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Sugammadex ED90 dose to reverse the rocuronium neuromuscular blockade in obese patients

Mauro Prado DA Silva1, Christiano Matsui1, Daniel Dongiou Kim1

  • 1- Central Hospital, Brotherhood of the Santa Casa de Misericórdia de São Paulo, Sevice of Anesthesiology, Sao Paulo, São Paulo State, Brazil.

Revista Do Colegio Brasileiro De Cirurgioes
|May 11, 2017
PubMed
Abstract

Insights

The minimum effective dose (ED90) of sugammadex for reversing moderate neuromuscular blockade induced by rocuronium in obese patients undergoing bariatric surgery was determined to be 2.39 mg/kg.

Area of Science:

  • Anesthesiology
  • Pharmacology

Background:

  • Neuromuscular blockade (NMB) reversal is critical in surgery.
  • Obesity can affect drug pharmacokinetics, potentially altering NMB reversal efficacy.

Purpose of the Study:

  • To determine the ED90 (minimum effective dose in 90% of patients) of sugammadex for reversing rocuronium-induced moderate NMB.
  • To evaluate sugammadex efficacy in patients with grade III obesity undergoing bariatric surgery.

Main Methods:

  • Prospective study utilizing a biased coin up-and-down sequential design.
  • Rocuronium 0.6 mg/kg was administered, with sugammadex doses ranging from 2.0 to 2.8 mg/kg.
  • Complete NMB reversal was defined as a T4/T1 ratio ≥0.9, measured by TOF.

Main Results:

  • 31 patients were evaluated; 26 showed successful reversal, and 5 experienced failure.
  • The mean time to complete NMB reversal was 213 seconds.
  • The calculated ED90 of sugammadex was 2.39 mg/kg (95% CI: 2.27-2.46 mg/kg).

Conclusions:

  • The ED90 of sugammadex for reversing moderate rocuronium-induced NMB in patients with grade III obesity is 2.39 mg/kg.
  • Sugammadex demonstrates effective reversal of NMB in this specific patient population.

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