Reversal of rocuronium-induced neuromuscular blockade with sugammadex compared with neostigmine during sevoflurane anaesthesia: results of a randomised, controlled trial

Blobner, Manfred; Eriksson, Lars; Scholz, Jens; Motsch, J.; Rocca, Giorgio Della; Prins, M. E.

doi:10.1097/eja.0b013e32833d56b7

Cited by 208 publications

(185 citation statements)

References 29 publications

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“…sugammadex under sevofl urane anesthesia and reported that the time needed to attain a TOF value over 0.90 was 18.6 minutes in neostigmine group and 1.5 minutes in sugammadex group 9 . Similarly, in our study TOF value to exceed 0.90 was three and ten minutes in Group S and N, respectively.…”

Section: Resultsmentioning

confidence: 99%

Comparison of Decurarization Using Sugammadex and Neostigmine After Rocuronium During Desflurane Anesthesia

Güleç¹,

Sarıkaş²,

Yeksan³

et al. 2015

Kafkas J Med Sci

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Section: Resultsmentioning

confidence: 99%

Comparison of Decurarization Using Sugammadex and Neostigmine After Rocuronium During Desflurane Anesthesia

Güleç¹,

Sarıkaş²,

Yeksan³

et al. 2015

Kafkas J Med Sci

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“…In contrast to neostigmine, sugammadex (Bridion Ò , Merck Sharp and Dohme (MSD), Oss, the Netherlands) has the potential to achieve reliable, complete and rapid reversal of both moderate and deep rocuronium-and vecuronium-induced neuromuscular blockade [3][4][5][6].…”

mentioning

confidence: 99%

A randomised controlled trial comparing sugammadex and neostigmine at different depths of neuromuscular blockade in patients undergoing laparoscopic surgery*

et al. 2012

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SummaryDeep neuromuscular blockade during certain surgical procedures may improve operating conditions. Sugammadex can be used to reverse deep neuromuscular blockade without waiting for spontaneous recovery. This randomised study compared recovery times from neuromuscular blockade induced by rocuronium 0.6 mg.kg , using sugammadex 4 mg.kg )1 administered at 1-2 post-tetanic count (deep blockade) or neostigmine 50 lg.kg )1 (plus atropine 10 lg.kg )1 ) administered at the re-appearance of the second twitch of a train-of-four stimulation (moderate blockade), in patients undergoing laparoscopic surgery. The primary efficacy variable was the time from the start of sugammadex ⁄ neostigmine administration to recovery of the train-of-four ratio to 0.9. Patients receiving sugammadex recovered 3.4 times faster than patients receiving neostigmine (geometric mean (95% CI) recovery times of 2.4 (2.1-2.7) and 8.4 (7.2-9.8) min, respectively, p < 0.0001). Moreover, 94% (62 ⁄ 66) of sugammadex-treated patients recovered within 5 min, vs 20% (13 ⁄ 65) of neostigmine-treated patients, despite the difference in the depth of neuromuscular blockade at the time of administration of both drugs. The ability to provide deep neuromuscular blockade throughout the procedure but still permit reversal at the end of surgery may enable improved surgical access and an enhanced visual field.

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“…Blobner M ve ark. [10], 198 hasta üzerinde yaptığı randomize kontrollü bir çalışmada rokuronyum ile nöromusküler blok sağ-lanan hastalara TOF 2 olduğunda sugammadeks 2 mg/kg ya da neostigmin 50 µg/kg dozunda verilmiştir. TOF oranının 0,9'a ulaşma zamanı karşılaştırıldığında sugammadeks grubunda 1,4 dk, neostigmin grubunda ise 17,6 dk olarak ölçülmüş, çalışmanın ikinci kısmında aynı ölçümler vekuronyumla da yapılmıştır.…”

Section: Discussionunclassified

Comparison of Sugammadex and Neostigmine in Short Term Surgery

Koç¹

2015

Ann Clin Anal Med

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ÖzetAmaç: Bu çalışmada kısa süreli elektif cerrahide; rokuronyumla oluşturulan nöromusküler bloğun geri döndürülmesinde sugammadeks ve neostigminin klinik etki ve maliyeti karşılaştırıldı. Gereç ve Yöntem: Yazılı onayları alındık-tan sonra, ASA I-III, öngörülen cerrahi süresi 90 dakikayı aşmayan, 18-65 yaş arası 33 hasta randomize edilerek iki gruba ayrıldı (Grup Sugammadeks, n=16; Grup Neostigmin, n=17). Anestezi indüksiyonunda tüm hastalara fentanil 1-2 µg/kg, tiopental 5-7 mg/kg, rokuronyum 0,6 mg/kg verildi. İdame-de % 50 O2-N2O ve % 1 sevofluran kullanıldı. Nöromusküler blok seviyesi akselomyolografi metoduyla train-o-four (TOF) stimulasyon ile monitorize edildi. Ameliyat sırasında TOF ölçümleri yapılarak TOF 3 olduğunda 0.1-0.2 mg kg ek rokuronyum yapıldı. Cerrahi sonunda TOF 2 olunca Grup S'ye 2 mg/kg sugammadeks yapılırken Grup N'ye 50 µg/kg neostigmin ve 20 µg/ kg atropin uygulandı. Bulgular: Gruplar arasında demografik özellikler benzerdi. TOF oranı 0,9'a ulaşma ve ekstübasyon süreleri Grup S'de ve Grup N'e göre anlamlı olarak kısaydı (2,3±0,9 dk, 9,4±2,7dk ve 6,6±1,6 dk., 12.9±2 dk) (p<0,001). Hasta başına ortalama maliyet Grup S'de, Grup N'e göre anlamlı olarak fazlaydı. (3,13±0,47 TL, 135,36±17,86 TL) (p<0,001). Tartışma: Rokuronyum sonrası nöromusküler fonksiyonların geri dönmesinde TOF oranı 0.9 olması 2 mg/kg sugammadex ile 50 µg/kg neostigmine göre daha hızlı olmakla birlikte sugammadeks neostigminden çok daha pahalıdır. Anahtar KelimelerSugammadeks; Neostigmin; Nöromusküler Blok Abstract Aim: This study compared the efficacy and cost effectivines of sugammadex and neostigmine for reversal of neuromuscular blockade induced by rocuronium for short term elective surgery. Material and Method: After written informed consent, 33 patients aged 18-65, ASA I-III, who were undergoing short term surgery (<90 min) were randomly selected and divided into two groups (Group Sugamadex, n=16; group Neostigmine, n=17). All patients were given 1,5 µg kg-1 fentanyl, 5-7 mgkg-1 thiopental, 0,6 mg kg-1 rocuronium for anaesthesia induction. Anaesthetic maintenance was ensured through 50% O2-N2O and 1% sevoflurane. Neuromuscular blockade was monitored using acceleromyography and a train-of-four (TOF) mode of stimulation. During surgery maintenance doses of 0.1-0.2 mgkg-1 rocuronium were administered according to reappearance of the third response of the TOF. Patients were given sugammadex 2 mg kg_1(group S) or neostigmine 50 µg kg_1 (with atropine 20 µg kg_1) (group N) at reappearance of the second response of the TOF after the last dose of rocuronium in the end of the surgery. Results: Demographic properties were similar in the two groups. Time to recovery of the TOF ratio of 0.9 and extubation time after sugammadex compared with neostigmine were significantly shorter, being 2.3 ± 0.9 versus 9.4 ± 2.7 min and 6.6 ± 1.6 versus 12.9 ± 2 (P<0.001). The costs were higher in group S (71.2 ± 9.8 $ ) than group N (1.7 ± 0.2 $) per patient (p<0.001). Discussion: Recovery of neuromuscular function after rocuronium to a TOF ...

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Reversal of rocuronium-induced neuromuscular blockade with sugammadex compared with neostigmine during sevoflurane anaesthesia: results of a randomised, controlled trial

Abstract: Sugammadex achieved significantly faster recovery of neuromuscular function after rocuronium to a TOF ratio of 0.9 compared with neostigmine (Clinicaltrials.gov identifier: NCT00451217).

Cited by 208 publications

References 29 publications

Comparison of Decurarization Using Sugammadex and Neostigmine After Rocuronium During Desflurane Anesthesia

Comparison of Decurarization Using Sugammadex and Neostigmine After Rocuronium During Desflurane Anesthesia

A randomised controlled trial comparing sugammadex and neostigmine at different depths of neuromuscular blockade in patients undergoing laparoscopic surgery*

Comparison of Sugammadex and Neostigmine in Short Term Surgery

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