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

B. Brueckmann, N. Sasaki, P. Grobara, M. K. Li, T. Woo, J. De Bie, M. Maktabi, J. Lee, J. Kwo, R. Pino, A. S. Sabouri, F. Mcgovern, A. K. Staehr-Rye, M. Eikermann

Research output: Contribution to journalArticlepeer-review

111 Scopus citations

Abstract

Background This study aimed to investigate whether reversal of rocuronium-induced neuromuscular blockade with sugammadex reduced the incidence of residual blockade and facilitated operating room discharge readiness. Methods Adult patients undergoing abdominal surgery received rocuronium, followed by randomized allocation to sugammadex (2 or 4 mg kg-1) or usual care (neostigmine/glycopyrrolate, dosing per usual care practice) for reversal of neuromuscular blockade. Timing of reversal agent administration was based on the providers' clinical judgement. Primary endpoint was the presence of residual neuromuscular blockade at PACU admission, defined as a train-of-four (TOF) ratio <0.9, using TOF-Watch® SX. Key secondary endpoint was time between reversal agent administration and operating room discharge-readiness; analysed with analysis of covariance. Results Of 154 patients randomized, 150 had a TOF value measured at PACU entry. Zero out of 74 sugammadex patients and 33 out of 76 (43.4%) usual care patients had TOF-Watch® SX-assessed residual neuromuscular blockade at PACU admission (odds ratio 0.0, 95% CI [0-0.06], P<0.0001). Of these 33 usual care patients, 2 also had clinical evidence of partial paralysis. Time between reversal agent administration and operating room discharge-readiness was shorter for sugammadex vs usual care (14.7 vs 18.6 min respectively; P=0.02). Conclusions After abdominal surgery, sugammadex reversal eliminated residual neuromuscular blockade in the PACU, and shortened the time from start of study medication administration to the time the patient was ready for discharge from the operating room.

Original languageEnglish (US)
Pages (from-to)743-751
Number of pages9
JournalBritish Journal of Anaesthesia
Volume115
Issue number5
DOIs
StatePublished - Nov 2015
Externally publishedYes

Keywords

  • neostigmine/glycopyrrolate
  • neuromuscular blockade
  • neuromuscular blocking agents
  • randomized-controlled trial
  • rocuronium
  • sugammadex

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Fingerprint

Dive into the research topics of 'Effects of sugammadex on incidence of postoperative residual neuromuscular blockade: A randomized, controlled study'. Together they form a unique fingerprint.

Cite this