Role Of Sugammadex Research Articles

Sugammadex Use Outside of the Postoperative Setting.

Sugammadex rapidly reverses the nondepolarizing neuromuscular blocking agents (NMBAs) rocuronium and vecuronium. The role of sugammadex is not well-defined outside of the postoperative setting. This study aims to describe sugammadex use outside the postoperative setting for the reversal of nondepolarizing NMBAs. This was a single-center, retrospective cohort study conducted in patients who received sugammadex outside of the postoperative setting at an academic medical center between June 2016 and November 2022. The primary outcome was the effect of sugammadex use for rocuronium reversal, defined as any increase in train-of-four (TOF) after sugammadex administration and/or progress note documentation if TOF was unavailable. Secondary outcomes included adverse events and documentation of contraceptive counseling in patients taking hormonal contraceptives with child-bearing ability. A total of 14 383 patients received sugammadex during the study period. Of those patients, 39 (0.3%) were outside of the postoperative setting for the reversal of rocuronium and included in the study. Twenty-nine (74%) patients had an increase in TOF after sugammadex administration and/or progress note documentation if TOF was unavailable. Ten (26%) patients lacked documentation regarding the effect of sugammadex. No adverse reactions were reported. Three (8%) patients included in the study were of child-bearing ability, and 1 of the 3 patients was counseled on using an alternative method of contraception following sugammadex administration. There is a paucity of literature for the use of sugammadex outside of the postoperative setting. This study found that while the use of sugammadex was rare, overall, it was safe and well-tolerated.

The role of sugammadex in endovascular interventions on cerebral vessels

Highlights. The article discusses the features of general anesthesia in patients with cerebrovascular diseases using the relaxant binding agent sugammadex.Aim. To evaluate the effectiveness of sugammadex in endovascular management of cerebrovascular diseases.Methods. The study included 57 patients who underwent endovascular treatment of cerebrovascular disease under general anesthesia. The experimental group included 29 patients who were injected with sugammadex - a selective relaxant binding agent for reversal of neuromuscular block induced by rocuronium. The comparison group included 28 patients who did not undergo decurarization (n = 13), or it was performed with neostigmine (n = 15). Acceleromyography was used to monitor the state of neuromuscular function.Result. Onset of action and duration of action of rocuronium at a dose of 0.9 mg/kg did not differ between the groups. The neuromuscular recovery time was 2.14 [1.67; 2.59] minutes after administration of sugammadex, compared with spontaneous 35.8 [31.5; 40.4] minutes and neostigmine-induced 22.1 [16.8; 27.3] minutes (p<0.001). No adverse or allergic reactions were noted after administration of the relaxant binding agent.Conclusion. Using a specific antidote sugammadex to eliminate the effect of rocuronium helps to restore neuromuscular function within 2–3 minutes and assess the neurological status of patients immediately after the endovascular treatment of cerebrovascular disease.

Role of sugammadex in the treatment of anaphylaxis due to rocuronium in children: Extrapolation from adult and animal reports.

Allergic reactions are generalized hypersensitivity processes triggered by different antigenic stimuli, resulting in the end effect of mast cell degranulation and adverse physiologic effects. During the perioperative period, the most commonly identified agents include antibiotics, neuromuscular blocking agents (rocuronium and succinylcholine), chlorhexidine, and iodinated dyes for radiologic imaging. Sugammadex is a novel agent for the reversal of neuromuscular blockade achieved with rocuronium or vecuronium. Its unique mechanism of action, whereby it encapsulates and forms a one-to-one complex with rocuronium, has led to its anecdotal use as an adjunct in the treatment of anaphylactic and anaphylactoid reactions following rocuronium. The current manuscript discusses the potential use of sugammadex in the treatment of allergic reactions following the administration of rocuronium, reviews previous anecdotal reports of its use in these scenarios, and provides recommendations for future care.

The Role of Sugammadex in the JSA Airway Management Guideline：Does Induction of Anesthesia Become Safer by Using Sugammadex?

The Role of Sugammadex in the JSA Airway Management Guideline：Does Induction of Anesthesia Become Safer by Using Sugammadex?

Role of Sugammadex as Reversal Agent in Patients Extubated Immediately After Isolated Coronary Artery Bypass Grafting Surgery

Role of Sugammadex as Reversal Agent in Patients Extubated Immediately After Isolated Coronary Artery Bypass Grafting Surgery

Anaesthetic management and the role of sugammadex in a patient with Churg-Strauss syndrome.

Anaesthetic management and the role of sugammadex in a patient with Churg-Strauss syndrome.

Steroidal Nondepolarizing Neuromuscular Blocker Induced Allergic Reactions and Role of Sugammadex in Treatment

Steroidal Nondepolarizing Neuromuscular Blocker Induced Allergic Reactions and Role of Sugammadex in Treatment

A Review of the Safety and Efficacy of Sugammadex in Anesthetic Practice

Sugammadex, the first in a novel class of medications termed selective relaxant binding agents, was developed to rapidly and completely encapsulate aminosteroid neuromuscular blocking agents, thus removing them from the neuromuscular junction. When used properly, sugammadex has the potential to decrease the incidence of residual neuromuscular block and it's associated complications, as well as, avoid the side effects associated with cholinesterase inhibitors. Sugammadex may also have a role in the management of patients with difficult airways and rocuronium- induced anaphylaxis. Currently available in over 70 countries worldwide, fears of hypersensitivity reactions have delayed it's release in the United States. The article looks to examine the role of sugammadex in anesthesia and detail its pharmacologic profile.

The role of sugammadex in the development and modification of an allergic response to rocuronium: evidence from a cutaneous model*

The availability of sugammadex as a selective encapsulating agent for rocuronium has led to speculation that it may be useful in mitigating rocuronium-induced anaphylaxis. Off-label use of sugammadex for this indication has already been documented in case reports although there are theoretical objections to the likelihood of an allergen-binding agent's being able to attenuate the immunological cascade of anaphylaxis. Using a cutaneous model of anaphylaxis in rocuronium-sensitised patients, we were unable to demonstrate that sugammadex was effective in attenuating the type-1 hypersensitivity reaction after it has been triggered by rocuronium, but we were able to demonstrate that these patients are anergic to sugammadex-bound rocuronium. These findings demonstrate that a cyclodextrin can bind an allergen and exclude it from interacting with the immune system, and may potentially lead to novel applications in other allergic diseases. However, there is no evidence that sugammadex should be used for the treatment of rocuronium-induced anaphylaxis, and clinical management should follow established protocols.

General Anesthesia for C-Section. The Role of Sugammadex in the quality and safety of anesthesia. Case Report

C-section is one of the most common surgical procedures in the world, with 5% of the cases being managed under general anesthesia (7.5 million C-sections performed under general anesthesia every year). Due to its special circumstances (i.e., the patient has a full stomach, need for neuromuscular relaxation, mother-child wellbeing, the mother is expected to immediately provide care to the baby, and the procedure takes a short time), general anesthesia is a challenge in every case. This article discusses the case of a pregnant woman who required general anesthesia for an emergency C-section. The neuromuscular relaxant used was Rocuronium. The airway was secured promptly and the surgical conditions were appropriate. The procedure was finally reversed with sugammadex at a dose of 1mg/kg. The availability of new neuromuscular relaxation reversal agents contributes to safe management during anesthesia; furthermore, these agents limit the chances of a residual relaxation and allow better time control and depth of relaxation. Studies suggest sugammadex doses that will probably change with the advent of new trials, adapting them to the degree of neuromuscular relaxation obtained, and this will help to reduce costs and hence improve the availability of the drug in our ORs © 2012 Sociedad Colombiana de Anestesiología y Reanimación. Published by Elsevier. All rights reserved. La cesárea es una de las intervenciones quirúrgicas más realizadas en el planeta. En el 5% de los casos se practica bajo anestesia general (7,5 millones de anestesias generales para cesárea cada año). Debido a sus requerimientos particulares (paciente con estómago lleno, necesidad de relajación neuromuscular, bienestar del binomio madre-hijo, expectativas de pronta atención del recién nacido por parte la madre y relativa corta duración del procedimiento) la anestesia general representa un reto en cada intervencion. En este articulo se presenta el caso de una mujer gestante que requirio anestesia general para una cesarea de urgencia. Se utilizo rocuronio como relajante neuromuscular y se obtuvo un acceso rapido a la via aerea, asi como condiciones quirurgicas adecuadas. Al final se revirtio el procedimiento con sugammadex a dosis de 1 mg/kg. El surgimiento de nuevos agentes para la reversion de la relajacion neuromuscular contribuye a un manejo seguro durante el acto anestesico; ademas, estos agentes disminuyen la probabilidad de relajacion residual y permiten un mejor control del tiempo y de la profundidad de la relajacion. Los estudios sugieren dosis de sugammadex que muy probablemente cambiaran con el advenimiento de nuevos estudios, haciendolas ajustables al grado de relajacion neuromuscular que se tenga, lo cual ayudara a disminuir los costos y, por lo tanto, a aumentar la disponibilidad del medicamento en nuestros quirofanos. © 2012 Sociedad Colombiana de Anestesiología y Reanimación. Publicado por Elsevier. Todos los derechos resevados.