BACKGROUND Sugammadex allows rapid recovery from rocuronium-induced neuromuscular blockade. Succinylcholine is often used for brief surgeries but is associated with myalgia, headache, histamine release, and increased lactate levels. Thus, we hypothesized that succinylcholine may affect emergence agitation (EA) and compared the effects of succinylcholine and rocuronium-sugammadex on EA in patients undergoing closed reduction of a nasal bone fracture under general anesthesia. METHODS Forty-two patients were prospectively enrolled and allocated randomly to the succinylcholine group (group SC) or the rocuronium-sugammadex group (group RS; each n = 21). Neuromuscular block and its reversal were achieved with succinylcholine and normal saline in group SC, whereas rocuronium and sugammadex were administered in group RS. After surgery, the incidence of EA as a primary outcome, the incidence of dangerous EA, and duration of EA as secondary outcomes were compared. RESULTS The incidence of EA was higher in group SC than in group RS (90.5% vs. 47.6%, respectively; relative risk [RR] 4.3; 95% confidence interval [CI] 1.2 to 15.7; P = .006). The incidence of dangerous EA increased in group SC compared to group RS (33.3% vs. 4.8%, respectively; RR 2.1; 95% CI 1.3 to 3.4; P = .045). The duration of agitation was longer in group SC than in group RS [106.5 (65.1) vs. 40.4 (26.0) sec; mean difference 66.1 s; 95% CI 31.0 to 101.1; effect size 1.3; P = .001). CONCLUSION Succinylcholine increases the incidence, severity, and duration of EA compared to rocuronium-sugammadex in patients undergoing closed reduction of a nasal bone fracture. TRIAL REGISTRATION CRiS Registration number KCT0002673. Initial registration date was 31 January 2018 (Retrospectively registered).

中文翻译：

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闭合性鼻骨折复位后成人中琥珀酰胆碱和罗库溴铵-sugammadex出现躁动的比较：一项前瞻性随机对照试验。

背景技术Sugammadex可以从罗库溴铵诱导的神经肌肉阻滞中快速恢复。琥珀酰胆碱通常用于短暂手术，但与肌痛，头痛，组胺释放和乳酸水平升高有关。因此，我们假设琥珀酰胆碱可能会影响急躁情绪（EA），并比较了在全身麻醉下鼻骨骨折闭合复位的患者中，琥珀胆碱和罗库溴铵-sugammadex对EA的影响。方法前瞻性纳入42例患者，随机分为琥珀酰胆碱组（SC组）或罗库溴铵-sugammadex组（RS组；每组n = 21）。SC组用琥珀酰胆碱和生理盐水实现神经肌肉阻滞及其逆转，而RS组使用罗库溴铵和sugammadex。手术后 比较了EA作为主要结局的发生率，危险EA的发生率以及EA作为次要结局的持续时间。结果SC组的EA发生率高于RS组（分别为90.5％和47.6％；相对风险[RR] 4.3； 95％置信区间[CI] 1.2至15.7； P = .006）。与RS组相比，SC组的危险EA发生率增加（分别为33.3％和4.8％； RR为2.1； 95％CI为1.3至3.4； P = .045）。SC组的躁动持续时间长于RS组[106.5（65.1）vs. 40.4（26.0）秒；平均差66.1 s; 95％CI 31.0至101.1; 效果大小1.3; P = 0.001）。结论与罗库溴铵-sugammadex相比，琥珀酰胆碱在鼻骨折闭合复位的患者中增加了EA的发生率，严重程度和持续时间。试用注册CRiS注册号KCT0002673。初始注册日期为2018年1月31日（追溯注册）。