Sugammadex

Cada, Dennis J.; Levien, Terri; Baker, Danial E.

doi:10.1310/hpj5107-585

Cited by 14 publications

(9 citation statements)

References 35 publications

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“…In contrast, sugammadex does not interfere with the acetylcholinesterase receptor system. In addition, the use of sugammadex has been linked to a faster and predictable reversal of any degree of neuromuscular blockade, reduced incidence of residual neuromuscular block and more efficient utilization of healthcare resources ( 12 , 42 ). However, hypersensitivity reactions, cough, oral discomfort, increased partial thromboplastin time (PTT), severe bradycardia, and asystole have been also described after its administration ( 13 , 39 , 43 , 44 ).…”

Section: Discussionmentioning

confidence: 99%

Sugammadex versus neostigmine for neuromuscular blockade reversal in outpatient surgeries: A randomized controlled trial to evaluate efficacy and associated healthcare cost in an academic center

et al. 2022

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IntroductionNeuromuscular blockade is an essential component of the general anesthesia as it allows for a better airway management and optimal surgical conditions. Despite significant reductions in extubation and OR readiness-for-discharge times have been associated with the use of sugammadex, the cost-effectiveness of this drug remains controversial. We aimed to compare the time to reach a train-of-four (TOF) response of ≥0.9 and operating room readiness for discharge in patients who received sugammadex for moderate neuromuscular blockade reversal when compared to neostigmine during outpatient surgeries under general anesthesia. Potential reduction in time for OR discharge readiness as a result of sugammadex use may compensate for the existing cost-gap between sugammadex and neostigmine.MethodsWe conducted a single-center, randomized, double arm, open-label, prospective clinical trial involving adult patients undergoing outpatient surgeries under general anesthesia. Eligible subjects were randomized (1:1 ratio) into two groups to receive either sugammadex (Groups S), or neostigmine/glycopyrrolate (Group N) at the time of neuromuscular blockade reversal. The primary outcome was the time to reverse moderate rocuronium-induced neuromuscular blockade (TOF ratio ≥0.9) in both groups. In addition, post-anesthesia care unit (PACU)/hospital length of stay (LOS) and perioperative costs were compared among groups as secondary outcomes.ResultsThirty-seven subjects were included in our statistical analysis (Group S= 18 subjects and Group N= 19 subjects). The median time to reach a TOF ratio ≥0.9 was significantly reduced in Group S when compared to Group N (180 versus 540 seconds; p = 0.0052). PACU and hospital LOS were comparable among groups. Postoperative nausea and vomiting was the main adverse effect reported in Group S (22.2% versus 5.3% in Group N; p = 0.18), while urinary retention (10.5%) and shortness of breath (5.3%) were only experienced by some patients in Group N. Moreover, no statistical differences were found between groups regarding OR/anesthesia, PACU, and total admission costs.DiscussionSugammadex use was associated with a significantly faster moderate neuromuscular blockade reversal. We found no evidence of increased perioperative costs associated with the use of sugammadex in patients undergoing outpatient surgeries in our academic institution.Clinical trial registration[https://clinicaltrials.gov/] identifier number [NCT03579589].

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Section: Discussionmentioning

confidence: 99%

Sugammadex versus neostigmine for neuromuscular blockade reversal in outpatient surgeries: A randomized controlled trial to evaluate efficacy and associated healthcare cost in an academic center

et al. 2022

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“…The administration of sugammadex following local institution guidelines (2, 4, or 16 mg/kg, based on a train of four stimulation) [ 12 ] is crucial for preventing failed extubation and possible airway re-intervention. The re-intubation would contribute to an additional risk of perforation of the surgical site.…”

Section: Discussionmentioning

confidence: 99%

Challenging Airway Management in Patients With Zenker’s Diverticulum

Santos¹,

Santos²,

Kurnutala³

2021

Cureus

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“…Rocuronium enters the central cavity of sugammadex, forming a stable and tight complex via strong intermolecular forces, hydrogen bonds, and electrostatic interaction [26], and, therefore, rocuronium is rarely detached with sugammadex. Sugammadex may bind to hormonal contraceptives [25,27], but the interactions of sugammadex with other drugs have not been reported to date.…”

Section: Discussionmentioning

confidence: 99%

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

Koo

Hwang

Min

et al. 2020

JCM

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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.

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Sugammadex

Cited by 14 publications

References 35 publications

Sugammadex versus neostigmine for neuromuscular blockade reversal in outpatient surgeries: A randomized controlled trial to evaluate efficacy and associated healthcare cost in an academic center

Sugammadex versus neostigmine for neuromuscular blockade reversal in outpatient surgeries: A randomized controlled trial to evaluate efficacy and associated healthcare cost in an academic center

Challenging Airway Management in Patients With Zenker’s Diverticulum

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

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