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Sugammadex: a selective relaxant binding agent for reversal of neuromuscular block
Rosemary M G Hogg1, Rajinder K Mirakhur
1Department of Anaesthetics and ICM, Queen's University, Belfast, UK.
Abstract:
Neostigmine, the currently used agent for reversal of neuromuscular block, has several drawbacks, such as a slow onset of peak effect, inability to reverse deep block and the occurrence of widespread muscarinic effects. Sugammadex is a new class of reversal agent that acts by encapsulating the molecules of the relaxants rocuronium and vecuronium, for which it is a specific antagonist. Clinical trials in over 2000 subjects have shown it to be effective for reversal of block by these two relaxants even from deep levels, in doses of 2.0-4.0 mg/kg. Sugammadex can also reverse an intense (profound) high-dose rocuronium block, but the dose required in this situation is 16.0 mg/kg. The agent has been found to be safe so far, with few side effects.
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