Essay On Sugammadex

When administered, sugammadex forms a water-soluble complex with aminosteroid non-depolarizing agents, thereby reversing NMB.22 Sugammadex has an affinity for aminosteroids as follows: rucoronium> vecuronium> pancuronium.1 Specifically, sugammadex is 2.5 times more selective for rocuronium than vecuronium.23 Sugammadex acts three to eight times faster than neostigmine to reverse a NMB.24 Due to its highly selective reversal of rocuronium-induced NMB, there is a new but growing interest in intraoperative administration of sugammadex during Motor Evoked Potentials (MEP) mapping. During surgical interventions, myogenic MEPs are affected by anesthesia. Anesthetics used during such procedures include ketamine, etomidate, propofol, and frequently muscle relaxants. Muscle relaxants such as rocuronium dampen the amplitude of MEPs and make monitoring difficult.25 The United States’ Food and Drug Administration (FDA) approved sugammadex as a neuromuscular blockade (NMB) reversal drug in December 2015.6 Prior to this, a wealth of previous international research had already demonstrated the ability of sugammadex to reverse NMB in an effective and timely manner.27
While sugammadex was only just approved by the FDA in 2015, it has been widely used around the European Union since its approval by …show more content…
Geldner et al. in a multicenter clinical trial assessed recovery times from deep neuromuscular blockade using sugammadex when compared with moderate neuromuscular blockade (re-appearance of the second twitch of train-of-four stimulation) using neostigmine in patients undergoing laparoscopic cholecystectomy or appendectomy under general anesthesia. Sugammadex recovery time was found to be 3.4 times faster when compared to neostigmine group. Also, the extubation time and discharge time from OR were reduced when using sugammadex as a reversal