Sugammadex and neostigmine dose-finding study for reversal of residual neuromuscular block at a train-of-four ratio of 0.2 (SUNDRO20)†,

British Journal of Anaesthesia
N KaufholdH Fink

Abstract

The aim of this dose-finding study was to evaluate the dose-response relationship of sugammadex and neostigmine to reverse a commonly observed level of incomplete recovery from rocuronium-induced neuromuscular block, that is, a train-of-four ratio (TOFR) ≥0.2. Ninety-nine anaesthetized patients received rocuronium 0.6 mg kg(-1) i.v. for tracheal intubation and, if necessary, incremental doses of 0.1-0.2 mg kg(-1). Neuromuscular monitoring was performed by calibrated electromyography. Once the TOFR recovered to 0.2, patients were randomized to receive sugammadex (0.25, 0.5, 0.75, 1.0, or 1.25 mg kg(-1) i.v.), neostigmine (10, 25, 40, 55, or 70 µg kg(-1) i.v.), or saline (n=9 per group). Primary and secondary end points were the doses necessary to restore neuromuscular function to a TOFR≥0.9 with an upper limit of 5 and 10 min for 95% of patients, respectively. Neostigmine was not able to fulfil the end points. Based on the best-fitting model, the sugammadex dose estimation for recovery to a TOFR≥0.9 for 95% of patients within 5 and 10 min was 0.49 and 0.26 mg kg(-1), respectively. A residual neuromuscular block of a TOFR of 0.2 cannot be reversed reliably with neostigmine within 10 min. In the conditions studied, substantially l...Continue Reading

References

Jul 1, 1967·The Journal of Physiology·W D Paton, D R Waud
Jan 1, 1980·British Journal of Anaesthesia·J P PayneS Al Azawi
Mar 11, 1999·Anesthesia and Analgesia·C A LienJ J Savarese
Dec 26, 2001·Anesthesiology·Hans KirkegaardJames E Caldwell
Jul 20, 2007·Acta Anaesthesiologica Scandinavica·T Fuchs-BuderUNKNOWN 8th International Neuromuscular Meeting
Mar 18, 2010·Anesthesiology·Benoît PlaudJean Marty
Jun 13, 2013·Anesthesia and Analgesia·Yoshifumi KotakeJunzo Takeda

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Citations

Jan 21, 2016·British Journal of Anaesthesia·M Eikermann, T T Houle
Jun 22, 2016·Drugs·Gillian M Keating
Jul 28, 2016·Expert Opinion on Drug Metabolism & Toxicology·Stefan Josef Schaller, Heidrun Lewald
Aug 15, 2017·The Cochrane Database of Systematic Reviews·Ana-Marija HristovskaArash Afshari
Jan 19, 2019·Anaesthesia·A Kopman, M Naguib
Mar 3, 2018·Der Anaesthesist·C Unterbuchner, M Blobner
Jul 31, 2019·Expert Opinion on Drug Safety·Ghm HoningM Boon
May 16, 2020·Anaesthesia·A Bowdle, S Jelacic
Nov 8, 2016·Anesthesiology·Sorin J Brull, Aaron F Kopman
Jul 7, 2020·Current Opinion in Anaesthesiology·Christiane G Stäuble, Manfred Blobner
Oct 31, 2019·Anesthesia and Pain Medicine·Jin Sun KimHong Seuk Yang

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