Hemodynamic Effects of Sugammadex, a Randomized Comparison with Neostigmine-Glycopyrrolate

Abstract

A novel approach to reversing neuromuscular blockade is sugammadex (Org 25969). It acts by rapidly encapsulating steroidal NMBDs to form a stable complex at a 1:1 ratio and thus decreasing the free concentration of the drug from the plasma. The encapsulated complex of sugammadex and NMBDs are freely filtered by the glomerulus into the urine. The dose dependency can be readily explained by the need to bind more rocuronium in plasma as blockade becomes deeper. Sugammadex could solve the problems of residual paralysis and failed intubation . in view of the potential of sugammadex to reverse even a profound NMB, and its favourable safety profile, this agent may fulfil the criteria of an ideal reversal agent for rocuronium.