Display options
Cite
Cheong SH, Ki S, Lee J, et al. The combination of sugammadex and neostigmine can reduce the dosage of sugammadex during recovery from the moderate neuromuscular blockade. Korean J Anesthesiol. 2015;68(6):547-55doi: 10.4097/kjae.2015.68.6.547.
Cheong, S. H., Ki, S., Lee, J., Lee, J. H., Kim, M. H., Hur, D., Cho, K., Lim, S. H., Lee, K. M., Kim, Y. J., & Lee, W. (2015). The combination of sugammadex and neostigmine can reduce the dosage of sugammadex during recovery from the moderate neuromuscular blockade. Korean journal of anesthesiology, 68(6), 547-55. https://doi.org/10.4097/kjae.2015.68.6.547
Cheong, Soon Ho, et al. "The combination of sugammadex and neostigmine can reduce the dosage of sugammadex during recovery from the moderate neuromuscular blockade." Korean journal of anesthesiology vol. 68,6 (2015): 547-55. doi: https://doi.org/10.4097/kjae.2015.68.6.547
Cheong SH, Ki S, Lee J, Lee JH, Kim MH, Hur D, Cho K, Lim SH, Lee KM, Kim YJ, Lee W. The combination of sugammadex and neostigmine can reduce the dosage of sugammadex during recovery from the moderate neuromuscular blockade. Korean J Anesthesiol. 2015 Dec;68(6):547-55. doi: 10.4097/kjae.2015.68.6.547. Epub 2015 Nov 25. PMID: 26634077; PMCID: PMC4667139.
Copy Download .nbib Format: NLM
Share it on

Korean J Anesthesiol. 2015 Dec;68(6):547-55. doi: 10.4097/kjae.2015.68.6.547. Epub 2015 Nov 25.

The combination of sugammadex and neostigmine can reduce the dosage of sugammadex during recovery from the moderate neuromuscular blockade.

Korean journal of anesthesiology

Soon Ho Cheong, Seunghee Ki, Jiyong Lee, Jeong Han Lee, Myoung-Hun Kim, Dongki Hur, Kwangrae Cho, Se Hun Lim, Kun Moo Lee, Young-Jae Kim, Wonjin Lee

Affiliations

  1. Department of Anesthesiology and Pain Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.

PMID: 26634077 PMCID: PMC4667139 DOI: 10.4097/kjae.2015.68.6.547

Abstract

BACKGROUND: Sugammadex is a novel neuromuscular reversal agent, but its associated hypersensitivity reaction and high cost have been obstacles to its widespread use. In the interest of reducing the necessary dosage of sugammadex, the reversal time of the combined use of sugammadex and neostigmine from moderate neuromuscular blockade were investigated.

METHODS: The patients enrolled ranged in age from 18 to 65 years old with American Society of Anesthesiologists class 1 or 2. The subjects were randomly assigned into one of the four groups (Group S2, S1, SN, and N; n = 30 per group). The reversal agents of each groups were as follows: S2 - sugammadex 2 mg/kg, S1 - sugammadex 1 mg/kg, SN - sugammadex 1 mg/kg + neostigmine 50 µg/kg + glycopyrrolate 10 µg/kg, N - neostigmine 50 µg/kg + glycopyrrolate 10 µg/kg. The time to recovery of the train-of-four (TOF) ratio was checked in each group.

RESULTS: The time to 90% recovery of TOF ratio was 182.6 ± 88.9, 371.1 ± 210.4, 204.3 ± 103.2, 953.2 ± 379.7 sec in group S2, S1, SN and N, respectively. Group SN showed a significantly shorter recovery time than did group S1 and N (P < 0.001). However, statistically significant differences between the S2 and SN groups were not be observed (P = 0.291). No hypersensitivity reactions occurred in all groups.

CONCLUSIONS: For the reversal from rocuronium-induced moderate neuromuscular blockade, the combined use of sugammadex and neostigmine may be helpful to decrease the recovery time and can also reduce the required dosage of sugammadex. However, the increased incidence of systemic muscarinic side effects must be considered.

Keywords: Neostigmine; Neuromuscular blockade; Rocuronium; Sugammadex

References

  1. Anaesthesia. 2012 Sep;67(9):991-8 - PubMed
  2. Anesthesiology. 1985 Oct;63(4):440-3 - PubMed
  3. Anesth Analg. 2007 Mar;104(3):569-74 - PubMed
  4. J Crit Care. 2009 Mar;24(1):29-35 - PubMed
  5. Br J Anaesth. 2008 Mar;100(3):373-9 - PubMed
  6. Anaesthesia. 2011 Mar;66(3):217-9 - PubMed
  7. Anesth Analg. 1997 Dec;85(6):1359-61 - PubMed
  8. Br J Anaesth. 2010 Nov;105(5):558-67 - PubMed
  9. Pharmacotherapy. 2007 Aug;27(8):1181-8 - PubMed
  10. Anesthesiology. 2003 May;98(5):1042-8 - PubMed
  11. Clin Drug Investig. 2010;30(12):867-74 - PubMed
  12. Br J Anaesth. 1971 May;43(5):478-85 - PubMed
  13. Br J Anaesth. 2010 Nov;105(5):610-9 - PubMed
  14. Anesthesiology. 2010 Nov;113(5):1010-1 - PubMed
  15. Anaesthesia. 2014 Nov;69(11):1251-7 - PubMed
  16. Anesthesiology. 2003 May;98(5):1037-9 - PubMed
  17. Br J Anaesth. 2009 Jul;103(1):115-29 - PubMed
  18. Korean J Anesthesiol. 2015 Feb;68(1):1-2 - PubMed
  19. Acta Anaesthesiol Scand. 1992 Nov;36(8):812-8 - PubMed
  20. Br J Anaesth. 2012 Aug;109(2):216-8 - PubMed
  21. Eur J Anaesthesiol. 2010 Oct;27(10):874-81 - PubMed
  22. Anesthesiology. 2006 Apr;104(4):667-74 - PubMed
  23. Curr Opin Anaesthesiol. 2010 Aug;23(4):461-5 - PubMed
  24. Anaesthesia. 2009 Mar;64 Suppl 1:45-54 - PubMed
  25. Acta Anaesthesiol Taiwan. 2012 Dec;50(4):183-4 - PubMed
  26. Acta Anaesthesiol Scand. 1997 Oct;41(9):1095-1103 - PubMed
  27. Korean J Anesthesiol. 2013 Dec;65(6):493-4 - PubMed
  28. Br J Anaesth. 2007 Mar;98(3):302-16 - PubMed

Publication Types