Effects of sugammadex on incidence of postoperative residual neuromuscular blockade: a randomized, controlled study

Brueckmann, B.; Sasaki, Nobuo; Grobara, Peter; Li, M.K.; Woo, Tiffany; Bie, Joris de; Maktabi, Maryam; Lee, J.; Kwo, Jean; Pino, Richard M.; Sabouri, Abdolnabi S; McGovern, Francis; Staehr‐Rye, A. K.; Eikermann, Matthias

doi:10.1093/bja/aev104

Cited by 183 publications

(169 citation statements)

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“…Alternatively, the challenge of cells with SGX or other structurally similar agents can modulate K V 3.1 channels where the closed channel conformation represents the high-affinity binding site. It also needs to be noted that, according to minimal reaction scheme shown here, the dissociation constant for SGX treatment was calculated to be 17.5 μM, a value that can be clinically achievable [1, 3, 5]. …”

Section: Discussionmentioning

confidence: 99%

“…Sugammadex (SGX) is recognized as a modified γ-cyclodextrin with a lipophilic core and a hydrophilic periphery, and it has been used clinically for reversal of neuromuscular blockade caused by rocuronium or vecuronium during general anesthesia [1–5]. A previous report showed that addition of SGX could cause neuronal apoptosis in primary cultures [6].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Important modifications by sugammadex, a modified γ-cyclodextrin, of ion currents in differentiated NSC-34 neuronal cells

Hsu

Huang

et al. 2017

BMC Neurosci

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BackgroundSugammadex (SGX) is a modified γ-cyclodextrin used for reversal of steroidal neuromuscular blocking agents during general anesthesia. Despite its application in clinical use, whether SGX treatment exerts any effects on membrane ion currents in neurons remains largely unclear. In this study, effects of SGX treatment on ion currents, particularly on delayed-rectifier K+ current [I K(DR)], were extensively investigated in differentiated NSC-34 neuronal cells.ResultsAfter cells were exposed to SGX (30 μM), there was a reduction in the amplitude of I K(DR) followed by an apparent slowing in current activation in response to membrane depolarization. The challenge of cells with SGX produced a depolarized shift by 15 mV in the activation curve of I K(DR) accompanied by increased gating charge of this current. However, the inactivation curve of I K(DR) remained unchanged following SGX treatment, as compared with that in untreated cells. According to a minimal reaction scheme, the lengthening of activation time constant of I K(DR) caused by cell treatment with different SGX concentrations was quantitatively estimated with a dissociation constant of 17.5 μM, a value that is clinically achievable. Accumulative slowing in I K(DR) activation elicited by repetitive stimuli was enhanced in SGX-treated cells. SGX treatment did not alter the amplitude of voltage-gated Na+ currents. In SGX-treated cells, dexamethasone (30 μM), a synthetic glucocorticoid, produced little or no effect on L-type Ca2+ currents, although it effectively suppressed the amplitude of this current in untreated cells.ConclusionsThe treatment of SGX may influence the amplitude and gating of I K(DR) and its actions could potentially contribute to functional activities of motor neurons if similar results were found in vivo.Electronic supplementary materialThe online version of this article (doi:10.1186/s12868-016-0320-5) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Important modifications by sugammadex, a modified γ-cyclodextrin, of ion currents in differentiated NSC-34 neuronal cells

Hsu

Huang

et al. 2017

BMC Neurosci

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show abstract

“…Furthermore it was suggested that the association between NMBAs and POPCs was dose-dependent (5,12,71,72). These studies severely criticized, were limited by many factors like the accuracy of data collection, insufficient propensity scoring and the questionable efficacy of qualitative neuromuscular monitoring (69,73).…”

Section: Debatementioning

confidence: 99%

Neuromuscular Block and Blocking Agents in 2018

Unterbuchner

2018

Turk J Anaesth Reanim

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“…In a recently pub-lished randomized study of 150 patients undergoing abdominal surgery [3] sugammadex was compared to neostigmine in terms of residual paralysis incidence in the PACU. No patient had residual paralysis after reversal with sugammadex (0 out of 74) compared to 43% after neostigmine (33 out of 76) usual care patients.…”

Section: Why Prefer Sugammadex?mentioning

confidence: 99%