Sugammadex for Neuromuscular Blockade Reversal

Postoperative residual neuromuscular blockade is associated with an increased risk of respiratory insufficiency, aspiration, and potential pulmonary complications. The standard of care for reversal of residual block centers on anticholinesterases such as neostigmine. However, these medications provide inconsistent or inadequate effect while being associated with potentially severe adverse effects. Sugammadex, a modified γ-cyclodextrine compound, is a recently approved agent for the reversal of blockade with aminosterodial neuromuscular blockers. Randomized controlled trials, in addition to a meta-analysis and a systematic review, have published results indicating faster and more consistent reversal of blockade while leading to fewer adverse events.