Neostigmine‐induced weakness after sugammadex

Szental, Joshua; Bramley, David E.

doi:10.1111/anae.14553

Cited by 3 publications

(2 citation statements)

References 4 publications

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“…Recently, a report indicated that rescue administration of sugammadex (200 mg) after administration of neostigmine (50–70 mg/kg) for NMB reversal can result in a paradoxical reduction in the TOF ratio. This is because complete removal of rocuronium from the neuromuscular junction by sugammadex may lead to a desensitized block, similar to a phase-2 block, due to excessive intrasynaptic acetylcholine made available after high-dose neostigmine administration [ 52 ].…”

Section: Use Of Sugammadex In a Special Clinical Situationmentioning

confidence: 99%

Advantages and pitfalls of clinical application of sugammadex

Lee

Jung

2020

Anesth Pain Med

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Sugammadex, a modified γ-cyclodextrin, is one of the drugs focused on in the anesthetic field because it provides rapid and complete reversal from neuromuscular blockade (NMB) by encapsulating rocuronium. Its introduction has revolutionized anesthesia practice because it is a safe, predictable, and reliable neuromuscular antagonist. Hence, its use has increased worldwide. Further, it has been in the spotlight for recovering from deep NMB in laparoscopic surgery and improving the surgical condition. Recently, studies have been conducted on the postoperative outcome after deep NMB and use of sugammadex in various clinical conditions. However, with increase in sugammadex use, reports regarding its complications are increasing. Appropriate dosing of sugammadex with quantitative neuromuscular monitoring is emphasized because under-dosing or over-dosing of sugammadex might be associated with unexperienced complications. Sugammadex is now leaping into an ideal reversal agent, changing the anesthesia practice.

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Section: Use Of Sugammadex In a Special Clinical Situationmentioning

confidence: 99%

Advantages and pitfalls of clinical application of sugammadex

Lee

Jung

2020

Anesth Pain Med

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“…Maintaining deep NMB improves surgical working conditions in selected laparoscopic procedures [10][11]. Sugammadex can rapidly reverse NMB, regardless of the depth of the block, and is associated with a lower risk of postoperative residual curarization after extubation [12][13][14]. A recent study showed that spontaneous recovery of NMB was an independent risk factor for PPC in intermediate-to-high risk patients undergoing abdominal surgery [15].…”

Section: Introductionmentioning

confidence: 99%

Effect of sugammadex on postoperative pulmonary complications in patients with respiratory dysfunction after laparoscopic gastric or intestinal surgery: A retrospective study

Yuan²,

Chen³

et al. 2020

Preprint

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Background Use of sugammadex is associated with fewer postoperative pulmonary complications. This study investigated the relationship between sugammadex and postoperative pulmonary complications (PPC) in specific patients with respiratory dysfunction. Methods The authors reviewed the electronic medical and anesthesia records of patients with respiratory dysfunction who had laparoscopic gastric or intestinal surgery at a single center between May 01, 2018, and December 31, 2019. The patients were divided into the sugammadex group and the non-sugammadex group, based on whether or not they received sugammadex. Binary logistic regression analyses were used to characterize the differences in incidence of PPC. Results A total of 112 patients were included, of which 46 patients (41.07%) received sugammadex. In the logistic regression analysis, the incidences of PPC were fewer in the sugammadex group. Postoperative fever [Odds Ratio (OR) 0.330; 95% Confidence Interval (CI) 0.137–0.793, p = 0.0213], postoperative ICU admission (OR 0.204; 95% CI 0.065 to 0.644, p = 0.007), cough (OR 0.143; 95% CI 0.061 to 0.333, p < 0.001), pleural effusion (all) (OR: 0.280; 95% CI 0.104 to 0.759, p = 0.012), pleural effusion (massive) (OR: 0.142; 95% CI 0.031 to 0.653, p = 0.012), and difficulty in breathing (OR: 0.111; 95% CI 0.014 to 0.849, p = 0.039) showed significant differences between the two groups. Conclusions Sugammadex-mediated reversal of neuromuscular blockade can reduce the PPC in patients with respiratory dysfunction.

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