Effects of rocuronium, sugammadex and rocuronium-sugammadex complex on coagulation in rats
Efeitos do rocurônio, sugamadex e complexo rocurônio-sugamadex sobre a coagulação em ratos
Estêvão Luiz Carvalho Braga, Ismar Cavalcanti, Nubia Verçosa, Alberto Schanaider, Louis Barrucand, Hans Donald de Boer, Luiz Vane
Abstract
Background and objectives
Sugammadex are an alternative pharmacological drug that is capable of reversing neuromuscular blockades without the limitations that are presented by anticholinesterase drugs. Coagulation disorders that are related to treatment with sugammadex were reported. The exact mechanism of the effects on coagulation are not fully understood. The objective of this research is to evaluate the effects of rocuronium, sugammadex and the rocuronium-sugammadex complex on coagulation in an experimental model in rats.
Methods
This is an experimental randomized animal study. Wistar rats were randomly assigned into the following groups: the Control group; the Ssal Group – 0.5 mL of intravenous saline; the Sugammadex Group – intravenous sugammadex (100 mg kg-1); and the Rocuronium-Sugammadex Group – intravenous solution with rocuronium (3.75 mg kg-1) and sugammadex (100 mg kg-1). Anaesthesia was performed by using isoflurane with controlled ventilation. Coagulation factors were measured 10 minutes after the end of the preoperative preparation and 30 minutes after the administration of the drugs in accordance with the chosen groups.
Results
Platelet counts, prothrombin times and activated partial thromboplastin times were similar between the groups and between the moments within each group. There were reductions in the plasma fibrinogen levels between sample times 1 and 2 in the Rocuronium-Sugammadex group (p = 0.035).
Conclusions
The rocuronium-sugammadex complex promoted reductions in plasma fibrinogen counts, although the levels were still within normal limits.
Keywords
Resumo
Introdução e objetivos
O sugamadex é uma substância farmacológica alternativa capaz de reverter o bloqueio neuromuscular sem as limitações apresentadas pelos anticolinesterásicos. Entretanto, há relatos de transtornos de coagulação relacionados ao tratamento com sugamadex, sem que mecanismos exatos de seus efeitos sobre a coagulação sejam totalmente compreendidos. O objetivo da presente pesquisa foi avaliar os efeitos do rocurônio, sugamadex e do complexo rocurônio-sugamadex sobre a coagulação em um modelo experimental com ratos.
Métodos
Este é um estudo randomizado experimental animal. Ratos Wistar foram aleatoriamente designados aos seguintes grupos: grupo controle; Grupo Ssal – 0,5 mL de solução salina intravenosa; Grupo sugamadex – sugamadex intravenoso (100 mg kg-1); e Grupo rocurônio-sugamadex – solução intravenosa com rocurônio (3,75 mg kg-1) e sugamadex (100 mg kg-1). A anestesia foi realizada utilizando-se isoflurano com ventilação controlada. Os fatores de coagulação foram medidos 10 minutos após o final do preparo pré-operatório e 30 minutos após a administração de drogas de acordo com os grupos escolhidos.
Resultados
Contagem de plaquetas, tempo de protrombina e tempo de tromboplastina parcial ativada foram semelhantes entre os grupos e entre os momentos dentro de cada grupo. Houve redução nos níveis de fibrinogênio plasmático entre os tempos 1 e 2 no grupo rocurônio-sugamadex (p = 0,035).
Conclusões
O complexo rocurônio-sugamadex promoveu reduções na contagem de fibrinogênio plasmático, apesar de os níveis continuarem dentro dos limites normais.
Palavras-chave
References
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