A Meta-Analysis on the Effect of Dexamethasone on the Sugammadex Reversal of Rocuronium-Induced Neuromuscular Block

Abstract

Sugammadex reverses the rocuronium-induced neuromuscular block by trapping the cyclopentanoperhydrophenanthrene ring of rocuronium. Dexamethasone shares the same steroidal structure with rocuronium. The purpose of this study was to evaluate the influence of dexamethasone on neuromuscular reversal of sugammadex after general anesthesia. Electronic databases were searched to identify all trials investigating the effect of dexamethasone on neuromuscular reversal of sugammadex after general anesthesia. The primary outcome was time for neuromuscular reversal, defined as the time to reach a Train-of-Four (TOF) ratio of 0.9 after sugammadex administration. The secondary outcome was the time to extubation after sugammadex administration. The mean difference (MD) and 95% CI were used for these continuous variables. Six trials were identified; a total of 329 patients were included. The analyses indicated that dexamethasone did not influence the time for neuromuscular reversal of sugammadex (MD −3.28, 95% CI −36.56 to 29.99, p = 0.847) and time to extubation (MD 25.99, 95% CI −4.32 to 56.31, p = 0.093) after general anesthesia. The results indicate that dexamethasone did not influence the neuromuscular reversal of sugammadex in patients after general anesthesia. Therefore, the dexamethasone does not appear to interfere with reversal of neuromuscular blockade with sugammadex in patients undergoing general anesthesia for elective surgery.

Optimization of a tri-drug treatment against lung cancer using orthogonal design in preclinical studies

“…Research into rocuronium mainly focuses on its effects on neuromuscular aspects ( Koo et al, 2020 ; Zhang et al, 2019 ) and rarely on lung cancer cell function. We found that rocuronium inhibited lung tumor cell proliferation at regular and high-dose concentrations.…”

Personalized Medicine for Classical Anesthesia Drugs and Cancer Progression

“…Recently, a metaanalysis on the effect of dexamethasone on the sugammadex reversal of rocuronium-induced neuromuscular block confirms the results discussed above. No effect was observed regarding the time required to extubate patients following general anesthesia or the time required for the neuromuscular reversal of sugammadex [31,32]. If taken 2/3 h before inducing anesthesia, a single dose of dexamethasone 8 mg reduced the rocuronium-induced block by 15-20%.…”