Sugammadex versus neostigmine reversal of moderate rocuronium-induced neuromuscular blockade in Korean patients
- Authors
- Woo, T.; Kim, K.S.; Shim, Y.H.; Kim, M.K.; Yoon, S.M.; Lim, Y.J.; Yang, H.S.; Phiri, P.; Chon, J.Y.
- Issue Date
- 2014
- Publisher
- Korean Society of Anesthesiologists
- Keywords
- Caucasian; Korean; Neostigmine; Neuromuscular blockade; Rocuronium; Sugammadex
- Citation
- Korean Journal of Anesthesiology, v.65, no.6, pp.501 - 507
- Indexed
- SCOPUS
KCI
- Journal Title
- Korean Journal of Anesthesiology
- Volume
- 65
- Number
- 6
- Start Page
- 501
- End Page
- 507
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/100696
- DOI
- 10.4097/kjae.2013.65.6.501
- ISSN
- 2005-6419
- 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. © the Korean Society of Anesthesiologists, 2013.
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