open access

Vol 45, No 2 (2013 Apr-Jun)
Review articles
Submitted: 2013-07-05
Accepted: 2013-07-05
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Sugammadex — indications and clinical use

Elżbieta Sokół-Kobielska
DOI: 10.5603/AIT.2013.0023
·
Anaesthesiol Intensive Ther 2013;45(2):106-110.

open access

Vol 45, No 2 (2013 Apr-Jun)
Review articles
Submitted: 2013-07-05
Accepted: 2013-07-05

Abstract

Neuromuscular blocking agents are a substantial element of anaesthesia in almost every surgical field. Nevertheless, their use has been associated with rises in mortality and morbidity. Of importance are: the general health state of the patient, liver and renal function, metabolism and excretion, active metabolites, side effects of muscle relaxants and, above all, residual paralysis. Prophylaxis of insufficient block reversal consists of neuromuscular transmission monitoring using acceleromyography and pharmacologic reversal of blockade. An ideal antagonistic agent should be characterised by rapid and complete reversal of blockade, disregarding its depth and total dose of muscle relaxant, lack of side effects and 100% excretion. These criteria are met by cyclodextrine gamma — sugammadex. In contrast to anticholinergic agents, which enhance the acetylcholine amount in the postsynaptic part of the neuromuscular junction, sugammadex encapsulates myorelaxing agent removing it from the junction. Sugammadex binds specifically only muscle relaxants of aminosteroid structure. In this paper, we present the current understanding of the characteristics, dosing, indications and side effects of sugammadex.

Abstract

Neuromuscular blocking agents are a substantial element of anaesthesia in almost every surgical field. Nevertheless, their use has been associated with rises in mortality and morbidity. Of importance are: the general health state of the patient, liver and renal function, metabolism and excretion, active metabolites, side effects of muscle relaxants and, above all, residual paralysis. Prophylaxis of insufficient block reversal consists of neuromuscular transmission monitoring using acceleromyography and pharmacologic reversal of blockade. An ideal antagonistic agent should be characterised by rapid and complete reversal of blockade, disregarding its depth and total dose of muscle relaxant, lack of side effects and 100% excretion. These criteria are met by cyclodextrine gamma — sugammadex. In contrast to anticholinergic agents, which enhance the acetylcholine amount in the postsynaptic part of the neuromuscular junction, sugammadex encapsulates myorelaxing agent removing it from the junction. Sugammadex binds specifically only muscle relaxants of aminosteroid structure. In this paper, we present the current understanding of the characteristics, dosing, indications and side effects of sugammadex.

Get Citation

Keywords

neuromuscular blocking agents, sugammadex; neuromuscular blockade, monitoring; neuromuscular blockade, residual block

About this article
Title

Sugammadex — indications and clinical use

Journal

Anaesthesiology Intensive Therapy

Issue

Vol 45, No 2 (2013 Apr-Jun)

Pages

106-110

DOI

10.5603/AIT.2013.0023

Bibliographic record

Anaesthesiol Intensive Ther 2013;45(2):106-110.

Keywords

neuromuscular blocking agents
sugammadex
neuromuscular blockade
monitoring
neuromuscular blockade
residual block

Authors

Elżbieta Sokół-Kobielska

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