Reversal of neuromuscular blockade by sugammadex does not affect EEG derived indices of depth of anesthesia

Abstract

Sugammadex does not affect level of anesthesia as determined by BIS or entropy levels.

The influence of frontal muscle electromyography on electroencephalography‐based depth of anaesthesia monitoring

“…I hypothesize that our method is more accurate in detecting the cause to the increased numerical values of BIS and Entropy. In the study by Illman et al (Illman et al 2010), the patients' depth of anaesthesia was deeper, offering an explanation why our results were different.…”

Effect of sugammadex or neostigmine neuromuscular block reversal on bispectral index monitoring of propofol/remifentanil anaesthesia

“…Conversely, it has been reported that mean BIS values [31.7 (9.9)] remained unchanged [32.0 (11.9)] 10 min after sugammadex reversal of the rocuronium-induced NMB. 19 The authors concluded that sugammadex had no influence on BIS monitoring. The most likely explanation for the discrepancy with our results is that they analysed all their study patients (those with and without EMG activity) in one group.…”

“…The most likely explanation for the discrepancy with our results is that they analysed all their study patients (those with and without EMG activity) in one group. 19 It is feasible that they included more patients exhibiting low EMG than those with high EMG activity, resulting in no statistically significant difference in BIS values when all their study patients were analysed as one group.…”

Sugammadex: A Review of Neuromuscular Blockade Reversal

“…Sugammadex 2 [12] or 2-16 [13] mg/kg did not affect the depth of anaesthesia (propofol and remifentanil [12] or thiopental, fentanyl and sevoflurane [13] anaesthesia), according to bispectral index (BIS) or Entropy TM values [12,13]. While a significant (p \ 0.05 vs. baseline) increase in BIS values was seen following administration of sugammadex 4 mg/kg to patients with high electromyographic activity during stable propofol and remifentanil anaesthesia, this reflected muscle activity reappearance, rather than consciousness [14].…”

“…A pooled safety analysis reported in the US prescribing information included data from 2914 patients receiving sugammadex 2, 4 or 16 mg/kg and 544 patients receiving placebo in phase I-III studies [6]. Adverse reactions occurring in C10 % of sugammadex recipients included pain (48 % of sugammadex 2 mg/kg recipients, 52 % of sugammadex 4 mg/kg recipients and 36 % of sugammadex 16 mg/kg recipients vs. 38 % of placebo recipients), nausea (23, 26 and 23 vs. 23 %), vomiting (11,12,15 vs. 10 %), headache (7, 5 and 10 vs. 8 %) and hypotension (4, 5, and 13 vs. 4 %) [6].…”