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Current Anesthesiology Reports
Erschienen in: Current Anesthesiology Reports 2/2016

01.06.2016 | Neuromuscular Blockade (GS Murphy, Section Editor)

The Use of Sugammadex in Clinical Practice: Which Patients Are Most Likely to Benefit?

verfasst von: Thomas Fuchs-Buder

Erschienen in: Current Anesthesiology Reports | Ausgabe 2/2016

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Abstract

The main advantage of sugammadex-based reversal compared with the “classical” acetylcholinesterase inhibitor-based concept is that it achieves more rapid and more reliable recovery and has the unique ability to dose-dependently reverse any degree of neuromuscular block. Mainly because of economic reasons, sugammadex is often limited to patient groups or procedures that are most likely to benefit from its unique features. In this context, patients with myasthenia gravis, patients undergoing (abdominal) laparoscopic surgery, patients undergoing short-acting procedures that require neuromuscular blockade, obese, elderly, or patients undergoing rapid sequence induction are most often cited. However, at comparable costs, this arbitrary limitation of sugammadex could be abolished.
Literatur
1.
Murphy GS, Szokol JW, Marymont JH, et al. Residual neuromuscular blockade and critical respiratory events in the postanesthesia care unit. Anesth Analg. 2008;107:130–7.CrossRef
2.
Murphy GS, Szokol JW, Avram MJ, et al. Intraoperative acceleromyography monitoring reduces symptoms of muscle weakness and improves quality of recovery in the early postoperative period. Anesthesiology. 2011;115:946–54.CrossRef
3.
Debaene B, Plaud B, Dilly MP, Donati F. Residual paralysis in the PACU after a single intubating dose of nondepolarizing muscle relaxant with an intermediate duration of action. Anesthesiology. 2003;98:1042–8.CrossRef
4.
Plaud B, Debaene B, Donati F, Marty J. Residual paralysis after emergence from anesthesia. Anesthesiology. 2010;112:1013–22.CrossRef
5.
Meistelman C, Fuchs-Buder T, Raft J. Sugammadex development and use in clinical practice. Curr Anesthesiol Rep. 2013;3:122–9.CrossRef
6.
Zhang MQ. Drug-specific cyclodextrines: the future of rapid neuromuscular drug reversal? Drugs Future. 2003;28(347):54.
7.
Bom A, Bradley M, Cameron K, et al. A novel concept of reversing neuromuscular block: chemical encapsulation of rocuronium bromide by a cyclodextrin-based synthetic host. Angew Chem Int Ed Eng. 2002;41:266–70.
8.
Sorgenfrei IF, Norrild K, Larsen PB, et al. Reversal of rocuronium-induced neuromuscular block by the selective relaxant binding agent sugammadex: a dose-finding and safety study. Anesthesiology. 2006;104:555–62.CrossRef
9.
Gijsenbergh F, Ramael S, Houwing N, van Iersel T. First human exposure of Org 25969, a novel agent to reverse the action of rocuronium bromide. Anesthesiology. 2005;103:695–703.CrossRef
10.
Groudine SB, Soto R, Lien C, Drover D, Roberts K. A randomized, dose-finding, phase II study of the selective relaxant binding drug, sugammadex, capable of safely reversing profound rocuronium-induced neuromuscular block. Anesth Analg. 2007;104:555–62.CrossRef
11.
Vanacker BF, Vermeyen KM, Struys MM, et al. Reversal of rocuronium-induced neuromuscular block with the novel drug sugammadex is equally effective under maintenance anesthesia with propofol or sevoflurane. Anesth Analg. 2007;104:563–8.CrossRef
12.
Lee C, Jahr JS, Candiotti KA, et al. Reversal of profound neuromuscular block by sugammadex administered three minutes after rocuronium: a comparison with spontaneous recovery from succinylcholine. Anesthesiology. 2009;110:1020–5.CrossRef
13.
De Boer HD, van Egmond J, Driessen JJ, Booij LH. A new approach to anesthesia management in myasthenia gravis: reversal of neuromuscular blockade by sugammadex. Rev Esp Anesthesiol Reanim. 2010;57:181–4.CrossRef
14.
Petrun AM, Mekis D, Kamenik M. Successful use of rocuronium and sugammadex in a patient with myasthenia. Eur J Anaesthesiol. 2010;27:917–8.CrossRef
15.
Naguib M, Flood P, McArdle JJ, Brenner HR. Advances in neurobiology of the neuromuscular junction. Implications for the anaesthesiologist. Anesthesiology. 2002;96:202–31.CrossRef
16.
De Boer HD, Fuchs-Buder T. Residual neuromuscular blockade and myasthenia gravis. Acta Anaesthesiol Scand. 2012;56:932–3.CrossRef
17.
de Boer HD, van Egmond J, Driessen JJ. Sugammadex in patients with myasthenia gravis. Anaesthesia. 2010;65:653.CrossRef
18.
Fujimoto M, Teraski S, Nishi M, Yamamoto T. Response to rocuronium and its determinants in patients with myasthenia gravis: A case-control study. Eur J Anaesthesiol. 2015;32:672–80.CrossRef
19.
• De Boer HD, Shields MO, Booij LH. Reversal of neuromuscular blockade with sugammadex in patients with myasthenia gravis: a case series of 21 patients and review of the literature. Eur J Anaesthesiol. 2014;31:715–21. The article gives a complete overview over the topic.
20.
Yamaguchi S, Ohno G, Kitamura J. Successful anesthetic management of laparoscopic rectopexy using rocuronium and sugammadex in a patient with Becker muscular dystrophy. Masui. 2014;63:1131–4.PubMed
21.
Matsuki Y, Hirose M, Tabata M, Nobukawa Y, Shigemi K. The use of sugammadex in a patient with myotonic dystrophy. Eur J Anaesthesiol. 2011;28:145–6.CrossRef
22.
Dell-Kuster S, Levano S, Burkhart CS, et al. Predictors of the variability in neuromuscular block duration following succinylcholine. A prospective, observational study. Eur J Anaesthesiol. 2015;32:687–96.CrossRef
23.
Fuchs-Buder T, Schmartz D. The never ending story or the search for a nondepolarising alternative to succinylcholine. Eur J Anaesthesiol. 2013;30:583–4.CrossRef
24.
25.
Pühringer FK, Rex C, Sielenkämper AW, et al. Reversal of profound, high-dose rocuronium-induced neuromuscular blockade by sugammadex at two different time points. An international, multicenter, randomized, dose-finding, safety assessor-blinded, phase II trial. Anesthesiology. 2008;109:188–97.CrossRef
26.
Sorensen MK, Bretlau C, Gätke MR, et al. Rapid sequence induction and intubation with rocuronium-sugammadex compared with succinylcholine. a randomised trial. Br J Anaesth. 2012;108:682–9.CrossRef
27.
Bisschops MMA, Hollemann C, Huitink JM. Can sugammadex save a patients in simulated „cannot intubate, cannot ventilate“situation? Anaesthesia. 2010;65:936–41.CrossRef
28.
Fernando PU, Viby-Mogensen J, Bonsu AK, et al. Relationsip between posttetanic count and response to carinal stimulation during vecuronium-induced neuromuscular blockade. Acta Anaesthesiol Scand. 1987;31:593–6.CrossRef
29.
Blobner M, Frick CG, Stäuble RB, et al. Neuromuscular blockade improves surgical conditions (NISCO). Surg Endosc. 2015;29:627–36.CrossRef
30.
Jones RK, Caldwell JE, Brull SJ, Soto RG. Reversal of profound rocuronium-induced blockade with sugammadex: a randomized comparison with neostigmine. Anesthesiology. 2008;109:816–24.CrossRef
31.
De Souza CM, Tardelli MA, Tedesco H, et al. Efficacy and safety of sugammadex in the reversal of deep neuromuscular blockade induced by rocuronium in patients with end stage renal disease: A comparative prospective clinical trial. Eur J Anaesthesiol. 2015;32:681–6.CrossRef
32.
Mirzakhani H, Welch CA, Eikermann M, Nozari A. Neuromuscular blocking agents for electroconvulsive therapy: a systematic review. Acta Anaesthesiol Scand. 2012;56:3–16.CrossRef
33.
34.
Boyce JR, Ness T, Castroman P, Gleysteen JJ. A preliminary study of the optimal anesthesia positioning for the morbidly obese patient. Obes Surg. 2003;13:4–9.CrossRef
35.
Gambee AM, Hertzka RE, Fisher DM, et al. Preoxygenation techniques: comparison of three minutes and four breaths. Anesth Analg. 1987;66:468–70.CrossRef
36.
Herbstreit F, Peters J, Eikermann M. Impaired upper airway integrity by residual neuromuscular blockade: increased airway collapsibility and blunted genioglossus muscle activity in response to negative pharyngeal pressure. Anesthesiology. 2009;110:253–60.CrossRef
37.
Pansard JL, Chauvin M, Lebrault C, Gauneau P, Duvaldestin P. Effects of an intubating dose of succinylcholine and atracurium on the diaphragm and the adductor pollicis muscle in humans. Anesthesiology. 1987;67:326–30.CrossRef
38.
Meistelman C, Plaud B, Donati F. Rocuronium (ORG 9426) neuromuscular blockade at the adductor muscles of the larynx and adductor pollicis in humans. Can J Anaesth. 1992;39:665–9.CrossRef
39.
Carron M, Veronese S, Foletto M, Ori C. Sugammadex allows fast-track bariatric surgery. Obes Surg. 2013;23:1558–63.CrossRef
40.
41.
• Murphy GS, Szokol JW, Avram MJ, et al. Residual neuromuscular block in the elderly: incidence and clinical implications. Anesthesiology 2015;123:1322–36. The article summarizes the risk of residual paralysis in the elderly.
42.
• Hardemark Cedborg AI, Sundman E, Boden K, et al. Pharyngeal function and breathing pattern during partial neuromuscular block in elderly. Effects on airway protection. Anesthesiology 2014;120:12–25. Gives new insights in paryngeal function in elderly and expands our understanding.
43.
Brueckmann B, Sasaki N, Grobara P, et al. Effects of sugammadex on incidence of postoperative residual neuromuscular blockade: a randomized, controlled study. Br J Anaesth. 2015;115:743–51.CrossRef
44.
Ledowski T, Falke L, Johnston F, et al. Retrospective investigation of postoperative outcome after reversal of residual neuromuscular blockade: sugammadex, neostigmine or no reversal. Eur J Anaesthesiol. 2014;31:423–9.CrossRef
45.
Kopman AF. Neostigmine versus sugammadex: which, when, and how much? Anesthesiology. 2010;113:1010–1.CrossRef
Metadaten
Titel
The Use of Sugammadex in Clinical Practice: Which Patients Are Most Likely to Benefit?
verfasst von
Thomas Fuchs-Buder
Publikationsdatum
01.06.2016
Verlag
Springer US
Erschienen in
Current Anesthesiology Reports / Ausgabe 2/2016
Elektronische ISSN: 2167-6275
DOI
https://doi.org/10.1007/s40140-016-0157-6

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