Abstract
Sugammadex provides a rapid pharmacological reversal of aminosteroid, as well as fewer pulmonary complications, a better physiological recovery, and shorter stays in the postanesthetic recovery unit (PACU). This retrospective analysis of our Centricity anesthesia database in 2017–2019 assessed the efficiency of sugammadex in real-life situations in two groups of surgical cancer patients (breast and abdominal surgery) based on the extubation time, operating room exit time, and length of PACU stay. Overall, 382 anesthesia records (131 breast and 251 abdominal surgeries) were extracted for the pharmacological reversal of neuromuscular blockades by neostigmine or sugammadex. Sugammadex was used for reversal in 91 breast and 204 abdominal surgeries. Sugammadex use did not affect the extubation time, operating room exit time, or length of PACU stay. However, the time to reach a 90% train of four (TOF) recovery was significantly faster in sugammadex patients: 2 min (1.5–8) in breast surgery and 2 min (1.5–7) in abdominal surgery versus 10 (6–20) and 9 min (5–20), respectively, for neostigmine (p < 0.05). Most patients who were reversed with sugammadex (91%) reached a TOF ratio of at least 90%, while 54% of neostigmine patients had a 90% TOF ratio recorded (p < 0.05). Factors other than pharmacological reversal probably influence the extubation time, operating room exit time, or PACU stay; however, sugammadex reliably shortened the time so as to reach a 90% TOF ratio with a better level of reversal.
Highlights
Sugammadex is the latest neuromuscular reversal agent developed for aminosteroids, mostly rocuronium, and has a significantly faster recovery in comparison to neostigmine [1]
In our department, monitoring the quantitative neuromuscular blockade is mandatory as part of our quality assurance program in anesthesia [9,10]
Specific and simple local guidelines, based on the level of paralysis, suggest pharmacological reversal of rocuronium, performed with either neostigmine or sugammadex, with their dosage given in a rational manner [11]
Summary
Sugammadex is the latest neuromuscular reversal agent developed for aminosteroids, mostly rocuronium, and has a significantly faster recovery in comparison to neostigmine [1].Sugammadex encapsulates the aminosteroid agent to create water-soluble complexes [2].By contrast, neostigmine acts as a competitive inhibitor of acetylcholinesterase and prolongs the presence of acetylcholine in the neuromuscular junction, which antagonizes the neuromuscular blocking agent and restores neuromuscular function [2]. Sugammadex is the latest neuromuscular reversal agent developed for aminosteroids, mostly rocuronium, and has a significantly faster recovery in comparison to neostigmine [1]. Sugammadex is characterized by its capacity to reverse the paralysis of a deep neuromuscular blockade within a short time [3,4,5]. Specific and simple local guidelines, based on the level of paralysis, suggest pharmacological reversal of rocuronium, performed with either neostigmine or sugammadex, with their dosage given in a rational manner [11]. In this retrospective analysis, using our Anesthesia Information Management
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
