Management of Residual Neuromuscular Blockade Recovery: Age-Old Problem with a New Solution

Neostigmine has been traditionally used as the agent of choice to reverse Neuromuscular Blockade (NMB) after muscle paralysis during general anesthesia. However, the use of neostigmine has not been without untoward events. Sugammadex is a novel drug that selectively binds to aminosteroid nondepolari...

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Bibliographic Details
Published in:Case reports in anesthesiology 2017-01, Vol.2017 (2017), p.1-4
Main Authors: Green, Michael S., Venkataramani, Ranjani, Gundigi Venkatesh, Archana
Format: Article
Language:English
Subjects:
Anesthesia
Anesthesiology
Case Report
Dosage and administration
Drug dosages
Gastrointestinal surgery
Medical personnel
Neostigmine
Patients
Studies
Ventilation
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Summary:Neostigmine has been traditionally used as the agent of choice to reverse Neuromuscular Blockade (NMB) after muscle paralysis during general anesthesia. However, the use of neostigmine has not been without untoward events. Sugammadex is a novel drug that selectively binds to aminosteroid nondepolarizing muscle relaxants and reverses even a deep level of NMB. Controversy exists regarding the optimal dose of sugammadex that is effective in reversing the NMB after the incomplete reversal with neostigmine and glycopyrrolate. We discuss a case where sugammadex reduced the time of the recovery from NMB in a patient who had incomplete antagonisms following adequate treatment with neostigmine, aiding timely extubation without persistent residual NMB, and hence prevented the requirement of postoperative ventilation and the improvement in patient care. More randomized control studies are needed in order to conclude the appropriate dose of sugammadex in cases of incomplete reversal.
ISSN:2090-6382
2090-6390
DOI:10.1155/2017/8197035