Use of sugammadex in patients with neuromuscular disorders: a systematic review of case reports.

Abstract:

BACKGROUND:Sugammadex is a modified gamma-cyclodextrin that acts by selectively encapsulating free amino-steroidal neuromuscular relaxants. Several case reports have been published on the use of sugammadex in patients with neuromuscular disorders that include neuromuscular junction diseases, myopathies, neuropathies, and motor neurone disorders. The primary aim of this review is to systematically review the evidence on the use of sugammadex in patients with this heterogeneous group of diseases and provide recommendations for clinical practice. METHODS:A systematic electronic search of Medline, Embase and CINAHL databases was done until June 2019, to identify case reports describing the use of sugammadex in adult surgical patients with neuromuscular disorders. RESULTS:Of the 578 records identified through database searches, 43 articles were finally included for the systematic review. Of these, 17 reports were on patients with myopathy, 15 reports on myasthenia gravis, 9 reports on motor neuron diseases and 2 reports on neuropathies. CONCLUSIONS:Majority of the articles reviewed report successful use of sugammadex to reverse steroidal muscle relaxants, especially rocuronium, in patients with neuromuscular diseases. However, with sugammadex, unpredictability in response and uncertainty regarding optimum dose still remain issues. Quantitative neuromuscular monitoring to ensure complete reversal and adequate postoperative monitoring is strongly recommended in these patients, despite the use of sugammadex.

journal_name

BMC Anesthesiol

journal_title

BMC anesthesiology

authors

Gurunathan U,Kunju SM,Stanton LML

doi

10.1186/s12871-019-0887-3

subject

Has Abstract

pub_date

2019-11-19 00:00:00

pages

213

issue

1

issn

1471-2253

pii

10.1186/s12871-019-0887-3

journal_volume

19

pub_type

杂志文章