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Title: Sugammadex Provides Faster Reversal of Vecuronium-Induced Neuromuscular Blockade Compared with Neostigmine: A Multicenter, Randomized, Controlled Trial
Authors: Khuenl-Brady, Karin S ×
Wattwil, Magnus
Vanacker, Bernard
Lora-Tamayo, José I
Rietbergen, Henk
Alvarez-Gómez, José A #
Issue Date: Jan-2010
Publisher: Williams & Wilkins
Series Title: Anesthesia and Analgesia vol:110 issue:1 pages:64-73
Abstract: Background: Sugammadex, a specifically designed gamma-cyclodextrin, is a selective relaxant binding drug that rapidly reverses rocuronium-induced and, to a lesser extent, vecuronium-induced neuromuscular blockade. In this study, we compared the efficacy of sugammadex and neostigmine for the reversal of vecuronium-induced neuromuscular blockade in patients scheduled for elective surgery. Methods: Patients aged >/=18 yr, ASA Class I-III, and scheduled for a surgical procedure under sevoflurane/opioid anesthesia received an intubating dose of vecuronium (0.1 mg/kg) and maintenance doses of 0.02-0.03 mg/kg at reappearance of the second twitch (T(2)) of train-of-four (TOF) if required. Neuromuscular blockade was monitored using acceleromyography (TOF-Watch(R) SX, Schering-Plough Ireland, Dublin, Ireland). At end of surgery, at reappearance of T(2) after the last dose of vecuronium, patients were randomized to receive either sugammadex (2 mg/kg) or neostigmine (50 mug/kg) plus glycopyrrolate (10 mug/kg) IV. The primary efficacy end-point was time from start of administration of sugammadex or neostigmine to recovery of TOF ratio to 0.9. Results: The geometric mean time to recovery of the TOF ratio to 0.9 was significantly faster with sugammadex compared with neostigmine (2.7 min [95% confidence interval {CI}]: 2.2-3.3) versus 17.9 min [95% CI: 13.1-24.3], respectively; P < 0.0001). The mean recovery times to a TOF ratio of 0.8 and 0.7 were also significantly shorter with sugammadex. No serious adverse events or unexpected side effects were reported with either drug. Conclusion: Sugammadex provided significantly faster reversal of vecuronium-induced neuromuscular blockade compared with neostigmine.
ISSN: 0003-2999
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Anesthesiology and Algology
× corresponding author
# (joint) last author

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