Retrospective evaluation of the effects of sugammadex and neostigmine on the IgE and eosinophil cationic protein in morbid obese patients

OBJECTIVE: This study was designed to show that allergic reactions with gamma cyclodextrin-related caused by sugammadex are not anaphylaxis but an anaphylactoid reaction.
METHODS: In this retrospective study, 83 morbidly obese patients, who underwent elective laparoscopic sleeve gastrectomy operation, were included. Patient data were obtained from patient files and electronic health records system (SARUS). The patients were divided into two groups 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 significantly positively, and weakly correlated with the preoperative ECP (p=0.311, p=0.045) and postoperative ECP (p=0.310, p=0.046) levels.
CONCLUSION: Allergic reactions that arise from sugammadex related 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.

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

Amaç
Bu çalýþma, sugammadeksin neden olduðu gama siklodekstrin ile iliþkili alerjik reaksiyonlarýn anafilaksi deðil, anafilaktoid bir reaksiyon olduðunu göstermek için tasarlanmýþtýr.
Method
Bu retrospektif çalýþmaya elektif laparoskopik sleeve gastrektomi operasyonu uygulanan 83 morbid obez hasta dahil edildi. Hasta verileri hasta dosyalarýndan ve elektronik saðlýk kayýtlarý sisteminden (SARUS) elde edilmiþtir. Hastalar sugammadeks (Grup S) ve neostigmin (Grup N) olarak iki gruba ayrýldý. Hasta verileri hasta preoperatif demografik özellikleri (yaþ, 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 anlamlý bir deðiþiklik yoktu (p> 0.05); ancak ECP düzeyleri her iki grupta da anlamlý olarak düþtü (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 anlamlý, pozitif ve zayýf korelasyon bulundu.
Sonuç
Gama siklodekstrin ile iliþkili sugammadeksin neden olduðu alerjik reaksiyonlar, IgE aracýlý olmayan anafilaktoid reaksiyonlardýr. Morbid obezitesi olan hastalarda intravenöz olarak 2 mg kg-1 sugammadeks uygulandýktan sonra anafilaktoid reaksiyon gözlenmedi. (NCI-2020-0210)