Articles That May Change Your Practice: Sugammadex

Abstract

Neuromuscular blocking agents (NMBAs) are typically used to facilitate tracheal intubation and mechanical ventilation and provide appropriate conditions for surgery. Prompt reversal of neuromuscular blockage is desired in some situations. Until recently, acetylcholinesterase inhibitors such as neostigmine were the only reversal agents available. These agents are often associated with bradycardia, bronchospasm, and other side effects because of their muscarinic activity. Anticholinergic agents used to relieve these muscarinic side effects are themselves associated with other unacceptable side effects. Russell D. MacDonald, MD, MPH, FCFP, FRCPC, is the medical director at Ornge Transport Medicine; medical director at Toronto Paramedic Services; an associate professor in the Faculty of Medicine at the University of Toronto; and an attending staff member at Sunnybrook Health Sciences Centre in Toronto, Ontario, Canada. He can be reached at .