The combination of sugammadex and neostigmine can reduce the dosage of sugammadex during recovery from the moderate neuromuscular blockade

Background: Sugammadex is a novel neuromuscular reversal agent, but its associated hypersensitivity reaction and high cost have been obstacles to its widespread use. In the interest of reducing the necessary dosage of sugammadex, the rever-sal time of the combined use of sugammadex and neostigmine f...

Full description

Saved in:
Bibliographic Details
Published in:Korean journal of anesthesiology 2015-12, Vol.68 (6), p.547
Main Authors: Soon Ho Cheong, Seunghee Ki, Jiyong Lee, Jeong Han Lee, Myoung-hun Kim, Dongki Hur, Kwangrae Cho, Se Hun Lim, Kun Moo Lee, Young-jae Kim, Wonjin Lee
Format: Article
Language:Korean
Subjects:
Neostigmine
Neuromuscular blockade
Rocuronium
Sugammadex
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background: Sugammadex is a novel neuromuscular reversal agent, but its associated hypersensitivity reaction and high cost have been obstacles to its widespread use. In the interest of reducing the necessary dosage of sugammadex, the rever-sal time of the combined use of sugammadex and neostigmine from moderate neuromuscular blockade were investigated. Methods: The patients enrolled ranged in age from 18 to 65 years old with American Society of Anesthesiologists class 1 or 2. The subjects were randomly assigned into one of the four groups (Group S2, S1, SN, and N; n = 30 per group). The reversal agents of each groups were as follows: S2 - sugammadex 2 mg/kg, S1 - sugammadex 1 mg/kg, SN - sugammadex 1 mg/kg + neostigmine 50 μg/kg + glycopyrrolate 10 μg/kg, N - neostigmine 50 μg/kg + glycopyrrolate 10 μg/kg. The time to recovery of the train-of-four (TOF) ratio was checked in each group. Results: The time to 90% recovery of TOF ratio was 182.6 ± 88.9, 371.1 ± 210.4, 204.3 ± 103.2, 953.2 ± 379.7 sec in group S2, S1, SN and N, respectively. Group SN showed a significantly shorter recovery time than did group S1 and N (P < 0.001). However, statistically significant differences between the S2 and SN groups were not be observed (P = 0.291). No hyper-sensitivity reactions occurred in all groups. Conclusions: For the reversal from rocuronium-induced moderate neuromuscular blockade, the combined use of su-gammadex and neostigmine may be helpful to decrease the recovery time and can also reduce the required dosage of sugammadex. However, the increased incidence of systemic muscarinic side effects must be considered.
ISSN:2005-6419