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Sugammadex versus neostigmine reversal of moderate rocuronium-induced neuromuscular blockade in Korean patients

Authors
 Tiffany Woo  ;  Kyo Sang Kim  ;  Yon Hee Shim  ;  Mi Kyeong Kim  ;  Suk Min Yoon  ;  Young Jin Lim  ;  Hong Seuk Yang  ;  Phillip Phiri  ;  Jin Young Cho 
Citation
 KOREAN JOURNAL OF ANESTHESIOLOGY, Vol.65(6) : 501-507, 2013 
Journal Title
KOREAN JOURNAL OF ANESTHESIOLOGY
ISSN
 2005-6419 
Issue Date
2013
Keywords
Caucasian ; Korean ; Neostigmine ; Neuromuscular blockade ; Rocuronium ; Sugammadex
Abstract
BACKGROUND:
Rapid and complete reversal of neuromuscular blockade (NMB) is desirable at the end of surgery. Sugammadex reverses rocuronium-induced NMB by encapsulation. It is well tolerated in Caucasian patients, providing rapid reversal of moderate (reappearance of T2) rocuronium-induced NMB. We investigated the efficacy and safety of sugammadex versus neostigmine in Korean patients.
METHODS:
This randomized, safety assessor-blinded trial (NCT01050543) included Korean patients undergoing general anesthesia. Rocuronium 0.6 mg/kg was given prior to intubation with maintenance doses of 0.1-0.2 mg/kg as required. Patients received sugammadex 2.0 mg/kg or neostigmine 50 µg/kg with glycopyrrolate 10 µg/kg to reverse the NMB at the reappearance of T2, after the last rocuronium dose. The primary efficacy endpoint was the time from sugammadex or neostigmine administration to recovery of the train-of-four (TOF) ratio to 0.9. The safety of these medications was also assessed.
RESULTS:
Of 128 randomized patients, 118 had evaluable data (n = 59 in each group). The geometric mean (95% confidence interval) time to recovery of the TOF ratio to 0.9 was 1.8 (1.6, 2.0) minutes in the sugammadex group and 14.8 (12.4, 17.6) minutes in the neostigmine group (P < 0.0001). Sugammadex was generally well tolerated, with no evidence of residual or recurrence of NMB; four patients in the neostigmine group reported adverse events possibly indicative of inadequate NMB reversal.
CONCLUSIONS:
Sugammadex was well tolerated and provided rapid reversal of moderate rocuronium-induced NMB in Korean patients, with a recovery time 8.1 times faster than neostigmine. These results are consistent with those reported for Caucasian patients.
Files in This Item:
T201305917.pdf Download
DOI
10.4097/kjae.2013.65.6.501
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Shim, Yon Hee(심연희) ORCID logo https://orcid.org/0000-0003-1921-3391
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/89292
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