Sugammadex: clinical development and practical use

Abstract

the selective relaxant binding agents. Sugammadex can reverse residual paralysis by encapsulating free circulating non depolarizing muscle relaxants. The mains advantages of sugammadex when compared with conventional anticholinesterase agents are a much faster recovery time and the unique ability, for the first time, to reverse rapidly and efficiently deep levels of neuromuscular blockade. However it only works for reversal of rocuronium or vecuronium-induced neuromuscular blockade. When administered 3 min after rocuronium the use of a large dose (16 mg/kg) can even reverse rocuronium significantly faster than the spontaneous recovery after succinylcholine.

Keywords: Cyclodextrins; Neostigmine; Neuromuscular block; Residual neuromuscular blockade; Rocuronium; Sugammadex.

Fig. 1

Time to recovery of a 0.9 TOF ratio from deep rocuronium-induced neuromuscular blockade after administration of sugammadex or neostigmine (adapted from Ref 26). TOF: train of four.

Fig. 2

Recommended doses of sugammadex depending of the degree of neuromuscular blockade. NMBA: neuromuscular blockade, PTC: plasma thromboplastin component, TOF: train of four.