The use of rocuronium and sugammadex in paediatric renal transplantation

Carlos, Ricardo Vieira; Torres, Marcelo Luís Abramides; Boer, H. de

doi:10.1097/eja.0000000000000338

Cited by 20 publications

(14 citation statements)

References 13 publications

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“…Other anecdotal experience has reported the use of sugammadex to reverse neuromuscular blockade following renal transplantation and in heart transplant recipients . Carlos et al .…”

Section: Discussionmentioning

confidence: 99%

Current evidence for the use of sugammadex in children

Tobias

2016

Pediatric Anesthesia

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Sugammadex is a novel pharmacologic agent, which reverses neuromuscular blockade with a mechanism that differs from the commonly used, acetylcholinesterase inhibitors. Although sugammadex has not received approval from the United States Food & Drug administration in children, its use has already been reported to reverse neuromuscular blockade in several clinical scenarios in the pediatric population including the 'cannot intubate-cannot ventilate' scenario. To date, there remains limited data from prospective trials in the pediatric-aged patient. Anecdotal use has been reported for the reversal of neuromuscular blockade in difficult clinical scenarios such as children with neuromuscular diseases including myasthenia gravis, Duchenne muscular dystrophy, and myotonic dystrophy.

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“…Other anecdotal experience has reported the use of sugammadex to reverse neuromuscular blockade following renal transplantation and in heart transplant recipients . Carlos et al .…”

Section: Discussionmentioning

confidence: 99%

Current evidence for the use of sugammadex in children

Tobias

2016

Pediatric Anesthesia

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“…In cases of severe renal failure; however, the clearance of sugammadex is reduced by 17-fold, and the elimination half-life is increased 15-fold and not licensed for severe renal failure. [ 11 , 12 ] Ciliary dysfunction may cause difficulties in removing secretions following general anesthesia. Hence, avoiding the residual block becomes even more important for ensuring the safety of the patient's airway.…”

Section: Discussionmentioning

confidence: 99%

Anesthetic management of a patient with Bardet-Biedl syndrome undergoing renal transplantation

Yaman

Çekmen

2020

Medicine

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Introduction: Bardet-Biedl syndrome, which compromises airway management and the cardiovascular and renal systems, is a rare ciliopathic syndrome characterized by multisystem involvement and varying genetic etiologies and clinical manifestations. Patient concerns: A 13-year-old female patient had a history of chronic renal failure, hypothyroidism, mental retardation, hypogonadotropic hypogonadism, obesity, and retinitis pigmentosa and was undergoing 4-hour hemodialysis 3 days a week. Diagnosis: We diagnosed Bardet-Biedl syndrome based on the results of genetic tests. Interventions: We performed renal transplantation under general anesthesia while considering the perioperative risks of airway obstruction and hypothermia. Outcomes: Multidisciplinary preoperative evaluation is crucial to avoid perioperative complications. The risk of an obstructed airway should be considered. Hypothyroidism is a rare consequence of Bardet-Biedl syndrome. Rocuronium and sugammadex are safe for anesthetic management during renal transplantation to address Bardet-Biedl syndrome. Conclusion: Safe anesthetic management can be achieved with the rigorous preoperative assessment of perioperative complications.

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“…Despite these concerns, sugammadex has been used both in the setting of renal insufficiency/failure and in patients undergoing renal transplantation. [58][59][60][61][62] Carlos et al reported reversal of profound neuromuscular blockade following renal transplantation in two pediatric patients (a 7year-old girl and a 14-year-old girl). 58 Despite significant residual neuromuscular blockade at the completion of the surgical procedure, sugammadex was effective and allowed for tracheal extubation.…”

Section: Renal Transplant Recipients and Renal Failure Patientsmentioning

confidence: 99%

Sugammadex: Applications in Pediatric Critical Care

Tobias

2020

J Pediatr Intensive Care

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Sugammadex is a novel pharmacologic agent, which reverses neuromuscular blockade with a mechanism that differs from acetylcholinesterase inhibitors such as neostigmine. There is a growing body of literature demonstrating its efficacy in pediatric patients of all ages. Prospective trials have demonstrated a more rapid and more complete reversal of rocuronium-induced neuromuscular blockade than the acetylcholinesterase inhibitor, neostigmine. Unlike the acetylcholinesterase inhibitors, sugammadex effectively reverses intense or complete neuromuscular blockade. It may also be effective in situations where reversal of neuromuscular blockade is problematic including patients with neuromyopathic conditions or when acetylcholinesterase inhibitors are contraindicated. This article reviews the physiology of neuromuscular transmission as well as the published literature, regarding the use of sugammadex in pediatric population including the pediatric intensive care unit population. Clinical applications are reviewed, adverse effects are discussed, and dosing algorithms are presented.

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The use of rocuronium and sugammadex in paediatric renal transplantation

Cited by 20 publications

References 13 publications

Current evidence for the use of sugammadex in children

Current evidence for the use of sugammadex in children

Anesthetic management of a patient with Bardet-Biedl syndrome undergoing renal transplantation

Sugammadex: Applications in Pediatric Critical Care

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