Sugammadex versus neostigmine reversal of moderate rocuronium-induced neuromuscular blockade in Korean patients

• Published in: Korean journal of anesthesiology 2013, 65(6), , pp.501-507
• Main Authors: Woo, Tiffany, Kim, Kyo Sang, Shim, Yon Hee, Kim, Mi Kyeong, Yoon, Suk Min, Lim, Young Jin, Yang, Hong Seuk, Phiri, Phillip, Chon, Jin Young
• Format: Article
• Language: English
• Subjects: caucasian; Clinical; korean; neostigmine; neuromuscular blockade; rocuronium; sugammadex; 마취과학
• ISSN: 2005-6419; 2005-7563
• DOI: 10.4097/kjae.2013.65.6.501

Rapid and complete reversal of neuromuscular blockade (NMB) is desirable at the end of surgery. Sugammadex reverses rocuronium-induced NMB by encapsulation. It is well tolerated in Caucasian patients, providing rapid reversal of moderate (reappearance of T2) rocuronium-induced NMB. We investigated the efficacy and safety of sugammadex versus neostigmine in Korean patients. This randomized, safety assessor-blinded trial (NCT01050543) included Korean patients undergoing general anesthesia. Rocuronium 0.6 mg/kg was given prior to intubation with maintenance doses of 0.1-0.2 mg/kg as required. Patients received sugammadex 2.0 mg/kg or neostigmine 50 µg/kg with glycopyrrolate 10 µg/kg to reverse the NMB at the reappearance of T2, after the last rocuronium dose. The primary efficacy endpoint was the time from sugammadex or neostigmine administration to recovery of the train-of-four (TOF) ratio to 0.9. The safety of these medications was also assessed. Of 128 randomized patients, 118 had evaluable data (n = 59 in each group). The geometric mean (95% confidence interval) time to recovery of the TOF ratio to 0.9 was 1.8 (1.6, 2.0) minutes in the sugammadex group and 14.8 (12.4, 17.6) minutes in the neostigmine group (P < 0.0001). Sugammadex was generally well tolerated, with no evidence of residual or recurrence of NMB; four patients in the neostigmine group reported adverse events possibly indicative of inadequate NMB reversal. Sugammadex was well tolerated and provided rapid reversal of moderate rocuronium-induced NMB in Korean patients, with a recovery time 8.1 times faster than neostigmine. These results are consistent with those reported for Caucasian patients.