Introduction: Sugammadex is an efficient reversal agent at any time, after neuromuscular blockade. It provides complete reversal for light or deep block facilitating rapid airway control and decreases anesthesia recovery period in outpatient surgeries in children. Patient and methods: After ethical committee approval, informed consent and sample size calculation, 70 patients planned for outpatient total bilateral tonsillectomy were divided randomly into 2 groups. Group S (n = 35) received 2 mg/kg sugammadex to reversing NMB achieved by rocuronium. Group N (n = 35) received 0.05 mg/kg neostigmine and atropine sulfate 0.01 mg/kg, and extubation time (time from administration of reversal agent to time of extubation), train-of-four ratio, time to reach train-of-four >0.9, and side effects were recorded. Results: There was no significant difference in demographic variables. TOF ratio after reversing was a statistically less in group S than in group N (p < 0.05). The time when TOF rate exceeded 0.9 and extubation time were less in group S than in group N with significant difference (p < 0.05). No adverse effect was recorded in both groups. Conclusions: Sugammadex has created a novel rapid, effective and reliable retrieval from NMB with rocuronium in children undergoing tonsillectomy with no side effects.
Highlights
Cystic Hygroma in Neck and Thorax.
Multi disciplinary team approach in the treatment of neck and thorax cystic hygroma.
Surgical management of huge cystic hygroma.
HighlightsThe mode of entry of the foreign body was unique as well as the force required to impale and break a knife blade in bone.The authors present a minimally invasive technique for dealing with this type of injury and highlight its challenges.This case report emphasis the need for baseline radiology in cases of traumatology especially those with vague history.The patient was examined by multiple physicians who did not detect the foreign body which could raise medico-legal issues.
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