Effectiveness on Smooth Extubation According to the Administration Time of Sugammadex

Study Overview
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Brief Summary
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After surgery is completed under general anesthesia, extubation is performed after recovery from anesthesia, and during this process, bucking, coughing, and rapid and excessive hemodynamic fluctuations occur very often. These phenomena can lead to high intrathoracic pressure, venous congestion, hematoma formation, or increased bleeding after major neck surgery. (1) They can also increase the risk of aerosol generation, which can transmit infection to health care workers. (2) For this, smooth extubation is required. Methods of administering drugs such as lidocaine, opioids, or dexmedetomidine have been proposed for smooth extubation. (3-5) As a disadvantage, the use of these drugs may be associated with deep sedation and reduced airway reflexes . Recently, Babu et al. (6) reported that bucking and coughing during extubation could be reduced by changing the timing of administering a muscle relaxant antagonist rather than using these sedative drugs, and thus complications related to extubation could be reduced. In general, in the awakening process, it was common to administer the muscle relaxant at the point of recovery of spontaneous breathing. However, Babu et al. demonstrated the possibility of safe and smooth extubation by changing the timing of administering neostigmine without the use of sedatives or narcotic analgesics, but there are few studies on sugammadex. Therefore, when recovering from general anesthesia, sugammadex was administered before and immediately after extubation to evaluate and compare smooth extubation (ie, comparison of the frequency of bucking and coughing).

Official Title
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Comparison of Smooth Emergence During Extubation After Anesthesia When Sugammadex is Administered Before and After Extubation

Conditions
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Smooth Emergence, Sugammadex, Extubation

Intervention / Treatment
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* Drug: sugammadex


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients undergoing general anesthesia for thyroid surgery. aged between 19 and 64 years American Society of Anesthesiologists physical status I and II Exclusion Criteria: patients with malformation or tumor of the upper respiratory tract patients with risk of aspiration obese cases with a BMI > 35 patients in which tracheal intubation was difficult refusal to participate in research

Ages Eligible for Study
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Minimum Age: 19 Years
Maximum Age: 64 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Control group<br>Routine anesthetic process; sugammadex is administered when spontaneous respiration is returned (before extubation) | |
| Experimental: Experimental group<br>sugammadex is administered just after extubation. | Drug: sugammadex<br>* sugammadex is administered just after extubation<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| extubation quality score | score based on the incidence and severity of coughing straining | immediate after extubation | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| time to respiration | time from withdrawal of anesthetics to respiration | immediate after extubation | 
| time to extubation | time from withdrawal of anesthetics to extubation | immediate after extubation | 
| sore throat in postanesthetic care unit | Scores obtained by questioning the patient in postanesthetic care unit | in postanesthetic care unit |