Comparing Effects of Sugammadex and Neostigmine on Postoperative Bowel Movements After Laparotomic Gynecological Operations

Abstract

ABS TRACT Objective: Gastrointestinal system dysfunction is a common postoperative complication. Especially after abdominal surgery it extends the length of stay in the hospital causing morbidity. Sugammadex is a drug being used in anesthesia routine which binds to steroid formed nondepolarizing muscle relaxants with high affinity and antagonizes neuromuscular block by a completely different mechanism from neostigmine which cause cholinesterase inhibition. We aimed to investigate the effect of sugammadex and neostigmine on return of bowel movements in the postoperative period. Material and Methods: 60 patients classified as American Society of Anesthesiologists (ASA) I, II aged between 18 and 65 years who underwent total abdominal hysterectomy, total abdominal hysterectomy, bilateral salpingo-oophorectomy and myomectomy operations under general anesthesia were randomized into two groups (Sugammadex, Group S, Neostigmine, Group N). Before the operation. Group S received 2 mg /kg sugammadex after spontaneous respiratory effort after operation, group N received 0.015 mg /kg atropine followed by 0.3 mg /kg neostigmine. Patients were examined by an independent physician at 0, 4, 8, 12, 24 hours postoperatively with a stethoscope for bowel movement. Patients gas release and defecation time were noted. Results: There was no statistically significant difference between groups in terms of demographic characteristics and total surgery time. Total anesthesia time was observed to be significantly shorter in group S. There was no difference between the groups in terms of the first gas extraction time, defecation time and patient discharge time. Conclusion: As a result, there was no difference between sugammadex and neostigmine in terms of returning time of postoperative bowel movements.