Reversal of rocuronium-induced neuromuscular block with the novel drug sugammadex is equally effective under maintenance anesthesia with propofol or sevoflurane

Anesth Analg. 2007 Mar;104(3):563-8. doi: 10.1213/01.ane.0000231829.29177.8e.

Abstract

In this study we investigated whether the novel reversal drug, sugammadex, is equally effective at reversing rocuronium-induced neuromuscular block (NMB) in patients under propofol or sevoflurane maintenance anesthesia. After receiving propofol for induction, patients were randomized to propofol (n = 21) or sevoflurane (n = 21). Rocuronium 0.6 mg/kg was administered for tracheal intubation. NMB was monitored using acceleromyography. At reappearance of the second twitch of the train-of-four ratio, sugammadex 2.0 mg/kg was administered by IV bolus. The primary end-point was time from start of sugammadex administration to recovery of train-of-four ratio to 0.9. Mean recovery time was 1.8 min after both propofol and sevoflurane anesthesia. The 95% confidence interval for the difference in recovery time between the 2 groups (-0.5 to +0.4 min) was well within the predefined equivalence interval (-1 to +1 min), indicating that recovery from NMB was unaffected by maintenance anesthesia. Thirteen patients (propofol n = 4; sevoflurane n = 9) experienced adverse events; these were treatment-related in 4 patients (propofol n = 3; sevoflurane n = 1). There were no treatment-related serious adverse events and no discontinuations or deaths. No residual paralysis occurred. The safety profile of sugammadex was somewhat more favorable under propofol than under sevoflurane anesthesia.

Publication types

  • Clinical Trial, Phase II
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Androstanols / administration & dosage
  • Androstanols / antagonists & inhibitors*
  • Anesthesia, General*
  • Anesthetics, Inhalation / administration & dosage
  • Anesthetics, Intravenous / administration & dosage
  • Female
  • Humans
  • Male
  • Methyl Ethers / administration & dosage*
  • Middle Aged
  • Neuromuscular Blockade / methods*
  • Neuromuscular Nondepolarizing Agents / administration & dosage
  • Neuromuscular Nondepolarizing Agents / antagonists & inhibitors*
  • Propofol / administration & dosage*
  • Rocuronium
  • Sevoflurane
  • Single-Blind Method
  • Sugammadex
  • Time Factors
  • Trachea / pathology
  • gamma-Cyclodextrins / administration & dosage*

Substances

  • Androstanols
  • Anesthetics, Inhalation
  • Anesthetics, Intravenous
  • Methyl Ethers
  • Neuromuscular Nondepolarizing Agents
  • gamma-Cyclodextrins
  • Sugammadex
  • Sevoflurane
  • Rocuronium
  • Propofol