Sugammadex versus neostigmine reversal of moderate rocuronium-induced neuromuscular blockade in Korean patients

Korean Journal of Anesthesiology

Phillip Phiri¹  Tiffany Woo¹  Hong Seuk Yang²  Kyo Sang Kim³  Mi Kyeong Kim⁴  Suk Min Yoon⁵  Young Jin Lim⁶  Jin Young Chon⁷  Yon Hee Shim⁸ 

[1] Clinical Development, Merck Sharp & Dohme Corp., Whitehouse Station, NJ, USA.;Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.;Department of Anesthesiology and Pain Medicine, College of Medicine, Hanyang University, Seoul, Korea.;Department of Anesthesiology and Pain Medicine, College of Medicine, Kyung Hee University Hospital, Seoul, Korea.;Department of Anesthesiology and Pain Medicine, Korea University Anam Hospital, Seoul, Korea.;Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea.;Department of Anesthesiology and Pain Medicine, The Catholic University of Korea, School of Medicine, St. Mary's Hospital, Seoul, Korea.;Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea.;

关键词: caucasian;    korean;    neostigmine;    neuromuscular blockade;    rocuronium;    sugammadex;   

DOI  :  10.4097/kjae.2013.65.6.501

来源: DOAJ

【 摘 要 】

BackgroundRapid 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.MethodsThis 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.ResultsOf 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.ConclusionsSugammadex 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.

【 授权许可】

Unknown