Is 1 mg/kg of sugammadex sufficient to reverse moderate neuromuscular block? A randomized clinical trial

  • Luis Moltó Department of Anaesthesiology, Parc Salut Mar, Barcelona, Spain
  • Juan L. Fernández-Candil Department of Anaesthesiology, Parc Salut Mar, Barcelona, Spain
  • Eliana López-Argüello Department of Anaesthesiology, Parc Salut Mar, Barcelona, Spain
  • Adela Benítez-Cano Department of Anaesthesiology, Parc Salut Mar, Barcelona, Spain
  • Ignacio Poves Department of Surgery, Parc Salut Mar, Barcelona, Spain
  • Xavier Santiveri Department of Anaesthesiology, Parc Salut Mar, Barcelona, Spain
Keywords: Neuromuscular block, Residual block, Rocuronium, Sugammadex, Neuromuscular monitoring

Abstract

Background:

Sugammadex has made it possible to reverse any type of rocuronium-induced block quickly and safely. The most frequent neuromuscular blockade is the moderate one where doses smaller than those recommended by the industry could get a full reversal.

Objective:

We aimed to evaluate the effectiveness of half the industry recommended dose of sugammadex to reverse a moderate neuromuscular block.

Methods:

Unicenter phase IV clinical trial that included 34 patients undergoing laparoscopic cholecystectomy. Intravenous general anesthesia was induced, with acceleromyographic monitoring of the neuromuscular block. After the intervention, the block was reversed with all or half the dose of sugammadex recommended for moderate blocks, using a blinded syringe.

Results:

Patient characteristics of the 2 groups were similar. Mean time to recovery was 3.6± 1.7minutes for the study group and 3.1 ± 1.7minutes for the control group (P=0.42). Reversal of the block was complete with a single dose of sugammadex in all patients. There was an important linear correlation between depth of block and time to recovery.

Conclusion:

Intraoperative monitoring is essential to allow us to individualize the dose of the neuromuscular blocking agent. To reverse a moderate block under neuromuscular monitoring, a dose of 1 mg/kg is sufficient in most cases and is equally safe and effective.

References

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How to Cite
1.
Moltó L, Fernández-Candil JL, López-Argüello E, Benítez-Cano A, Poves I, Santiveri X. Is 1 mg/kg of sugammadex sufficient to reverse moderate neuromuscular block? A randomized clinical trial. Colomb. J. Anesthesiol. [Internet]. 2019 Oct. 1 [cited 2024 Apr. 18];47(4):211-8. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/26

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Published
2019-10-01
How to Cite
1.
Moltó L, Fernández-Candil JL, López-Argüello E, Benítez-Cano A, Poves I, Santiveri X. Is 1 mg/kg of sugammadex sufficient to reverse moderate neuromuscular block? A randomized clinical trial. Colomb. J. Anesthesiol. [Internet]. 2019 Oct. 1 [cited 2024 Apr. 18];47(4):211-8. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/26
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