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Sugammadex use can decrease the incidence of post-operative urinary retention by avoiding anticholinergics: a retrospective study
Anesth Pain Med 2018;13(1):40-6
Published online January 31, 2018
© 2018 Korean Society of Anesthesiologists.

Jung-Eun Cha1, Sung Wook Park1, Young In Choi1, In Duk Oh1, Hee Yong Kang1, Sang Hyub Lee2, and Jeong-Hyun Choi1
Departments of 1Anesthesiology and Pain Medicine, 2Urology, College of Medicine, Kyung Hee University, Seoul, Korea
Correspondence to: Jeong-Hyun Choi, M.D., Ph.D.
Department of Anesthesiology and Pain Medicine, Kyung Hee University Hospital, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea
Tel: 82-2-958-8589
Fax: 82-2-958-8580
Received August 7, 2017; Revised September 6, 2017; Accepted September 27, 2017.
cc This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: Postoperative urinary retention (POUR) is a common complication after total knee arthroplasty (TKA) and associated with the use of anticholinergics. The introduction of sugammadex has decreased perioperative use of anticholinergics. Since anticholinergics may influence the detrusor muscle, the purpose of this study was to compare incidence of POUR between sugammadex and anticholinergic use for reversal of muscle relaxant.
Methods: This study was a retrospective cohort study in a university-affiliated hospital. A total of 571 patients who underwent TKA between 2015 and 2016 with an American Society of Anesthesiologists class ≤ 3 were included in this study. Patients who received sugammadex (group S, n = 208) were compared to those who received glycopyrrolate with pyridostigmine (group C, n = 363) for reversal of neuromuscular blockade. The primary outcome was the incidence of POUR. Secondary outcomes were hospital length of stay (HOS) and daily residual urine drained from intermittent catheterization. Demographic, intraoperative, and laboratory data were collected.
Results: The incidence of POUR was significantly lower in group S compared to group C (36.1 vs. 48.8%, P = 0.003). On post-operative day (POD) 0, there was no significant difference in the residual urine volume between the two groups. However, from POD 1 to POD 4, the residual urine volume was significantly lower in group S compared to group C. There was no significant difference in HOS between the two groups.
Conclusions: The use of sugammadex was associated with a lower incidence of POUR by avoiding glycopyrrolate in patients underwent TKA.
Key Words : Arthroplasty, replacement, knee, Cholinergic antagonists, Urinary retention.

January 2018, 13 (1)
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