Background: Sugammadex has been a revolutionary reversal of neuromuscular blockade. It is known to be highly efficient. However, a change in the coagulation profile is one of the most dangerous potential complications which is a concern for both surgeon and anesthetist. Bleeding may cause hypovolemic shock, hematoma, and so on. To investigate the effects of sugammadex on coagulation profiles in patients with thyroidectomy, we compared patients that were treated with either sugammadex or neostigmine.
Patients and Methods: Eighty patients with thyroid neoplasms undergoing thyroidectomy were randomly allocated to sugammadex group (group S) or neostigmine group (group N). Induction of anesthesia was preformed using propofol, sufentanil, and rocuronium. Group S received sugammadex 2.0mg/kg after trachea intubation, similarly Group N received neostigmine 40 μg/kg, for reversal of rocuronium-induced neuromuscular blockade. The intraoperative coagulation profiles were monitored after the rocuronium injection (T0), 10 minutes after reversal (T1) and 30 minutes after reversal (T2) by testing activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen (FIB), thrombin time (TT), and TEG-Haemonetics. Amount of bleeding was recorded during perioperative period.
Results: There was no significant difference in the thromboelastogram, APTT, PT, FIB, or TT measurements at each time point in Group N. The reaction time (R time) and kinetics time (K time) of Group S in T1 were significantly longer than the corresponding times at T0 and T2, and the R times were significantly longer than those in Group N at the same time points (P< 0.05). Additionally, in Group S, the APTT was prolonged in T1 and returned to normal in T2.
Conclusion: The result showed that sugammadex provided transient efficacy in prolonging the coagulation parameters, while neostigmine did not change the coagulation profile.



中文翻译：

---

舒更葡糖与新斯的明对甲状腺切除术患者术中凝血曲线的影响

背景：舒更葡糖是神经肌肉阻滞的革命性逆转。众所周知，它的效率很高。然而，凝血曲线的变化是最危险的潜在并发症之一，这是外科医生和麻醉师都关心的问题。出血可引起低血容量性休克、血肿等。为了研究舒更葡糖对甲状腺切除术患者凝血曲线的影响，我们比较了接受舒更葡糖或新斯的明治疗的患者。
患者和方法：80例接受甲状腺切除术的甲状腺肿瘤患者被随机分配到舒更葡糖组（S组）或新斯的明组（N组）。使用丙泊酚、舒芬太尼和罗库溴铵进行麻醉诱导。S组气管插管后给予舒更葡糖2.0mg/kg，N组同样给予新斯的明40μg/kg，用于逆转罗库溴铵所致的神经肌肉阻滞。通过检测活化部分促凝血酶原激酶时间（APTT）、凝血酶原时间（PT）、纤维蛋白原（FIB）、凝血酶时间 (TT) 和 TEG-Haemonetics。记录围手术期出血量。
结果：N组各时间点的血栓弹力图、APTT、PT、FIB或TT测量值无显着差异。T1组S组的反应时间（R时间）和动力学时间（K时间）明显长于对照组T0、T2相应时间，R时间明显长于N组同一时间点（P<0.05）。此外，在 S 组中，APTT 在 T1 时延长，在 T2 时恢复正常。
结论：结果表明，舒更葡糖在延长凝血参数方面具有瞬时疗效，而新斯的明不改变凝血曲线。