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. 2020 Apr 24;9(4):1240.
doi: 10.3390/jcm9041240.

A Meta-Analysis on the Effect of Dexamethasone on the Sugammadex Reversal of Rocuronium-Induced Neuromuscular Block

Chang-Hoon Koo  1 , Jin-Young Hwang  2   3 , Seong-Won Min  2   3 , Jung-Hee Ryu  1   3
Affiliations

A Meta-Analysis on the Effect of Dexamethasone on the Sugammadex Reversal of Rocuronium-Induced Neuromuscular Block

Chang-Hoon Koo et al. J Clin Med. .

Abstract

Sugammadex reverses the rocuronium-induced neuromuscular block by trapping the cyclopentanoperhydrophenanthrene ring of rocuronium. Dexamethasone shares the same steroidal structure with rocuronium. The purpose of this study was to evaluate the influence of dexamethasone on neuromuscular reversal of sugammadex after general anesthesia. Electronic databases were searched to identify all trials investigating the effect of dexamethasone on neuromuscular reversal of sugammadex after general anesthesia. The primary outcome was time for neuromuscular reversal, defined as the time to reach a Train-of-Four (TOF) ratio of 0.9 after sugammadex administration. The secondary outcome was the time to extubation after sugammadex administration. The mean difference (MD) and 95% CI were used for these continuous variables. Six trials were identified; a total of 329 patients were included. The analyses indicated that dexamethasone did not influence the time for neuromuscular reversal of sugammadex (MD -3.28, 95% CI -36.56 to 29.99, p = 0.847) and time to extubation (MD 25.99, 95% CI -4.32 to 56.31, p = 0.093) after general anesthesia. The results indicate that dexamethasone did not influence the neuromuscular reversal of sugammadex in patients after general anesthesia. Therefore, the dexamethasone does not appear to interfere with reversal of neuromuscular blockade with sugammadex in patients undergoing general anesthesia for elective surgery.

Keywords: dexamethasone; neuromuscular blockade; sugammadex.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram of included and excluded studies.
Figure 2
Figure 2
Time(s) to recovery of TOF ratio > 0.9. Dexamethasone vs. control.
Figure 3
Figure 3
Sensitivity analysis by excluding one trial at time(s) to recovery of TOF ratio > 0.9.
Figure 4
Figure 4
Time to extubation. Dexamethasone administration vs. control.
See this image and copyright information in PMC

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