ISSN: 2148-4902 | E-ISSN: 2536-4553
Northern Clinics of Istanbul Retrospective evaluation of the effects of Sugammadex and Neostigmine on the IgE and Eosinophil Cationic Protein in Morbid Obese Patients [North Clin Istanb]
North Clin Istanb. Ahead of Print: NCI-21298 | DOI: 10.14744/nci.2020.21298

Retrospective evaluation of the effects of Sugammadex and Neostigmine on the IgE and Eosinophil Cationic Protein in Morbid Obese Patients

Özkan Görgülü1, Mehmet Nuri Koşar2
1Department of Anesthesiology and Reanimation, Antalya Training and Research Hospital, Antalya, Turkey
2Department of General Surgery, Antalya Training and Research Hospital, Antalya, Turkey

Objective
This study was designed to show that allergic reactions with gamma cyclodextrin-related caused by sugammadex are not anaphylaxis, but an anaphylactoid reaction.
Materials and Methods
A total of 83 morbidly obese patients, who underwent elective laparoscopic sleeve gastrectomy operation, were included in this retrospective study. Patient data were obtained from patient files and electronic health records system (SARUS). The patients were divided into two groups named as sugammadex (Group S) and neostigmine (Group N). Patient data were recorded including patient preoperative demographics (age, gender) and preoperative and postoperative (12 hours later) levels of total IgE and ECP(Eosinophil cationic protein) levels.
Results
There was not a significant change in the total IgE levels in Group S or Group N (p>0.05); however, the levels of ECP significantly decreased in both groups (p<0.001, p = 0.01). In the patients in Group S; the preoperative levels of total IgE were found to be significantly, positively, and weakly correlated with the preoperative ECP(ρ=0.311, p=0.045) and postoperative ECP(ρ=0.310, p=0.046) levels.
Conclusion
Allergic reactions caused by sugammadex releated with gamma cyclodextrin are non-IgE mediated anaphylactoid reactions. Anaphylactoid reaction was not observed after administration of 2 mg kg-1 sugammadex intravenously in patients with morbid obesity.

Keywords: sugammadex, immunoglobulin e, cyclodextrins, eosinophil cationic protein, neostigmine, anaphylaxis

Morbid Obez Hastalarda Sugammadeks ve Neostigmin'in IgE ve Eozinofil Katyonik Protein üzerindeki etkilerinin retrospektif olarak değerlendirilmesi

Özkan Görgülü1, Mehmet Nuri Koşar2
1Department of Anesthesiology and Reanimation, Antalya Training and Research Hospital, Antalya, Turkey
2Department of General Surgery, Antalya Training and Research Hospital, Antalya, Turkey

Amaç
Bu çalışma, sugammadeksin neden olduğu gama siklodekstrin ile ilişkili alerjik reaksiyonların anafilaksi değil, anafilaktoid bir reaksiyon olduğunu göstermek için tasarlanmıştır.
Method
Bu retrospektif çalışmaya elektif laparoskopik sleeve gastrektomi operasyonu uygulanan 83 morbid obez hasta dahil edildi. Hasta verileri hasta dosyalarından ve elektronik sağlık kayıtları sisteminden (SARUS) elde edilmiştir. Hastalar sugammadeks (Grup S) ve neostigmin (Grup N) olarak iki gruba ayrıldı. Hasta verileri hasta preoperatif demografik özellikleri (yaş, cinsiyet) ve preoperatif ve postoperatif (12 saat sonra) toplam IgE ve ECP (Eozinofil katyonik protein) düzeyleri dahil olmak üzere kaydedildi.
Bulgular
Grup S veya Grup N'de toplam IgE düzeylerinde anlamlı bir değişiklik yoktu (p> 0.05); ancak ECP düzeyleri her iki grupta da anlamlı olarak düştü (p <0.001, p = 0.01). Grup S'deki hastalarda; preoperatif total IgE düzeyleri, preoperatif ECP (ρ = 0.311, p = 0.045) ve postoperatif ECP (ρ = 0.310, p = 0.046) seviyeleri ile anlamlı, pozitif ve zayıf korelasyon bulundu.
Sonuç
Gama siklodekstrin ile ilişkili sugammadeksin neden olduğu alerjik reaksiyonlar, IgE aracılı olmayan anafilaktoid reaksiyonlardır. Morbid obezitesi olan hastalarda intravenöz olarak 2 mg kg-1 sugammadeks uygulandıktan sonra anafilaktoid reaksiyon gözlenmedi. (NCI-2020-0210)

Anahtar Kelimeler: sugammadeks, immünoglobulin e, siklodekstrinler, eozinofil katyonik protein, neostigmin, anafilaksi



Corresponding Author: Özkan Görgülü
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