In the hour of Sugammadex

Abstract

Sugammadex is a modified gamma-cyclodextrin which is showing favorable outcomes regarding reversal of neuromuscular blockade, especially by rocuronium. It is designed to encapsulate rocuronium and being considered a new class of drugs as selective relaxant binding agents. It has given countless benefits to the patients at risk of incomplete or delayed recovery after neuromuscular block and has renown for another milestone in anesthesia practice. Recurrence of neuromuscular block has not been reported to be associated with the provided doses of sugammadex that are adequate for selected for reversal. Acceptable profiles are brought to light telling safety of sugammadex. However, some questions related to the twitch characteristics those resembled succinylcholine when reversal, the application for rocuronium anaphylaxis, and the hypersensitivity or anaphylaxis to sugammadex remain and are need of further investigation. It is imperative that potential problems that we need attention may include the patient's history of pulmonary disease and allergic disease for using sugammadex.

Intraoperative Anesthetic Management of Patients with Chronic Obstructive Pulmonary Disease to Decrease the Risk of Postoperative Pulmonary Complications after Abdominal Surgery

“…In this study, sugammadex consistently showed strong protective effects in various subgroups. Sugammadex immediately induces a solid and persistent reversal from neuromuscular blockade by encapsulating rocuronium or vecuronium molecules [35]. Recent studies have consistently reported that sugammadex prevents PPCs by avoiding the residual neuromuscular blockade, which is known to be common with conventional nondepolarizing agents [10,11,36].…”

Hypersensitivity associated with sugammadex administration: a systematic review

“…Out of the 25 records, 14 failed to meet the inclusion criteria. Four were in Japanese [14][15][16][17]; three were not primary investigations [18][19][20]; in the six from the MHRA, sufficient detail of the hypersensitivity reaction could not be disclosed owing to concerns over patient confidentiality; and one included a probable alternative explanation for the reaction [21]. We identified a total of 11 studies to be included in the qualitative analysis, including: two case series of three patients each [22,23]; six case reports [24][25][26][27][28][29]; an abstract [30]; and two clinical trials [7,31].…”

Sugammadex: What do we Know and What do we Still Need to Know? A Review of the Recent (2013 to 2014) Literature

“…In fact, Della Rocca et al 4 have warned that, in the context of residual neuromuscular block-related incidents, hospitals are increasingly likely to face questions or complaints if sugammadex was unavailable or not used. Nevertheless, even after ten review articles [4][5][6][7][8][9][10][11][12][13] in the last 18 months, anaesthetists still search to find definite answers to basic questions about the optimal use of sugammadex and its place in their practice.…”