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

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. CLINICAL TRIAL REGISTRATION:Clinicaltrials.gov:NCT01479764.

journal_name

Br J Anaesth

journal_title

British journal of anaesthesia

authors

Brueckmann B,Sasaki N,Grobara P,Li MK,Woo T,de Bie J,Maktabi M,Lee J,Kwo J,Pino R,Sabouri AS,McGovern F,Staehr-Rye AK,Eikermann M

doi

10.1093/bja/aev104

subject

Has Abstract

pub_date

2015-11-01 00:00:00

pages

743-51

issue

eissn

0007-0912

issn

1471-6771

pii

S0007-0912(17)31076-0

journal_volume

115

pub_type

杂志文章,随机对照试验

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