Sugammadex provides faster reversal of vecuronium-induced neuromuscular blockade compared with neostigmine: a multicenter, randomized, controlled trial.
| Autor: | Khuenl-Brady KS; Medical University Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria. karin.khuenl-brady@i-med.ac.at, Wattwil M, Vanacker BF, Lora-Tamayo JI, Rietbergen H, Alvarez-Gómez JA |
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| Jazyk: | angličtina |
| Zdroj: | Anesthesia and analgesia [Anesth Analg] 2010 Jan 01; Vol. 110 (1), pp. 64-73. Date of Electronic Publication: 2009 Aug 27. |
| DOI: | 10.1213/ane.0b013e3181ac53c3 |
| Abstrakt: | Background: Sugammadex, a specifically designed gamma-cyclodextrin, is a selective relaxant binding drug that rapidly reverses rocuronium-induced and, to a lesser extent, vecuronium-induced neuromuscular blockade. In this study, we compared the efficacy of sugammadex and neostigmine for the reversal of vecuronium-induced neuromuscular blockade in patients scheduled for elective surgery. Methods: Patients aged > or = 18 yr, ASA Class I-III, and scheduled for a surgical procedure under sevoflurane/opioid anesthesia received an intubating dose of vecuronium (0.1 mg/kg) and maintenance doses of 0.02-0.03 mg/kg at reappearance of the second twitch (T(2)) of train-of-four (TOF) if required. Neuromuscular blockade was monitored using acceleromyography (TOF-Watch SX, Schering-Plough Ireland, Dublin, Ireland). At end of surgery, at reappearance of T(2) after the last dose of vecuronium, patients were randomized to receive either sugammadex (2 mg/kg) or neostigmine (50 microg/kg) plus glycopyrrolate (10 microg/kg) i.v.. The primary efficacy end-point was time from start of administration of sugammadex or neostigmine to recovery of TOF ratio to 0.9. Results: The geometric mean time to recovery of the TOF ratio to 0.9 was significantly faster with sugammadex compared with neostigmine (2.7 min [95% confidence interval {CI}]: 2.2-3.3) versus 17.9 min [95% CI: 13.1-24.3], respectively; P < 0.0001). The mean recovery times to a TOF ratio of 0.8 and 0.7 were also significantly shorter with sugammadex. No serious adverse events or unexpected side effects were reported with either drug. Conclusion: Sugammadex provided significantly faster reversal of vecuronium-induced neuromuscular blockade compared with neostigmine. |
| Databáze: | MEDLINE |
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