Sugammadex in systemic mastocytosis

Becerra, Ángel Ignacio Lledó; Muiño-Palomar, V.; Cabrera-Doreste, S.; Rodríguez‐Pérez, Aurelio

doi:10.1007/s00101-021-01069-5

Cited by 2 publications

(2 citation statements)

References 32 publications

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“…Some of the consequence of the increased use of sugammadex in the everyday anesthesiologist’s activity require further consideration. Several articles in the medical literature highlight the risk of hypersensitivity, bradycardia, and hypotension [ 26 , 27 ] following administration of sugammadex, including anecdotical case reports that describe the potential evolution of this clinical picture into asystole [ 28 , 29 ]. The exact mechanism by which sugammadex may induce these hemodynamic impairments remains unknown.…”

Section: Discussionmentioning

confidence: 99%

REVersal of nEuromusculAr bLocking Agents in Patients Undergoing General Anaesthesia (REVEAL Study)

Greco

Caruso

Angelotti

et al. 2023

JCM

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Background: Neuromuscular blocking agent (NMBA) monitoring and reversals are key to avoiding residual curarization and improving patient outcomes. Sugammadex is a NMBA reversal with favorable pharmacological properties. There is a lack of real-world data detailing how the diffusion of sugammadex affects anesthetic monitoring and practice. Methods: We conducted an electronic health record analysis study, including all adult surgical patients undergoing general anesthesia with orotracheal intubation, from January 2016 to December 2019, to describe changes and temporal trends of NMBAs and NMBA reversals administration. Results: From an initial population of 115,046 surgeries, we included 37,882 procedures, with 24,583 (64.9%) treated with spontaneous recovery from neuromuscular block and 13,299 (35.1%) with NMBA reversals. NMBA reversals use doubled over 4 years from 25.5% to 42.5%, mainly driven by sugammadex use, which increased from 17.8% to 38.3%. Rocuronium increased from 58.6% (2016) to 94.5% (2019). Factors associated with NMBA reversal use in the multivariable analysis were severe obesity (OR 3.33 for class II and OR 11.4 for class III obesity, p-value < 0.001), and high ASA score (OR 1.47 for ASA III). Among comorbidities, OSAS, asthma, and other respiratory diseases showed the strongest association with NMBA reversal administration. Conclusions: Unrestricted availability of sugammadex led to a considerable increase in pharmacological NMBA reversal, with rocuronium use also rising. More research is needed to determine how unrestricted and safer NMBA reversal affects anesthesia intraoperative monitoring and practice.

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Section: Discussionmentioning

confidence: 99%

REVersal of nEuromusculAr bLocking Agents in Patients Undergoing General Anaesthesia (REVEAL Study)

Greco

Caruso

Angelotti

et al. 2023

JCM

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“…In contrast to nondepolarizing NMDAs, Succinylcholine does not interact with MRG-PRX2 and is considered safe for patients with mastocytosis [60][61][62]. Sugammadex can safely be used to reverse the neuromuscular blockade in patients with systemic mastocytosis [63].…”

Section: Perioperative Medications and Anesthesiamentioning

confidence: 99%

Challenges in Drug and Hymenoptera Venom Hypersensitivity Diagnosis and Management in Mastocytosis

Giannetti,

Nicoloro-SantaBarbara,

Godwin

et al. 2024

Diagnostics

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Mastocytosis is a myeloproliferative neoplasm characterized by abnormal proliferation and activation of clonal mast cells typically bearing the KITD816V mutation. Symptoms manifest due to the release of bioactive mediators and the tissue infiltration by neoplastic mast cells. Mast cell activation symptoms include flushing, pruritus, urticaria, abdominal cramping, diarrhea, wheezing, neuropsychiatric symptoms, and anaphylaxis. Up to 50% of patients with mastocytosis report a history of provoked and unprovoked anaphylaxis, with Hymenoptera venom and drugs the most common culprits. NSAIDs, antibiotics, vaccines, perioperative medications, and radiocontrast media are often empirically avoided without evidence of reactions, depriving patients of needed medications and placing them at risk for unfavorable outcomes. The purpose of this review is to highlight the most common agents responsible for adverse drug reactions in patients with mastocytosis, with a review of current epidemiology, diagnosis, and management of drug hypersensitivity and Hymenoptera venom allergy.

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Sugammadex in systemic mastocytosis

Cited by 2 publications

References 32 publications

REVersal of nEuromusculAr bLocking Agents in Patients Undergoing General Anaesthesia (REVEAL Study)

REVersal of nEuromusculAr bLocking Agents in Patients Undergoing General Anaesthesia (REVEAL Study)

Challenges in Drug and Hymenoptera Venom Hypersensitivity Diagnosis and Management in Mastocytosis

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