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Revista Cubana de Anestesiología y Reanimación

2014, Number 3

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Revista Cubana de Anestesiología y Reanimación 2014; 13 (3)

Reversal of vecuronium-induced neuromuscular blockade: sugammadex vs. neostigmine

Abreu DMG, Cordero EI, Pérez MG

Language: Spanish
References: 42
Page: 253-567
PDF size: 200.65 Kb.


ABSTRACT

Introduction: studies are available about the differences between reversal of neuromuscular blockers with sugammadex and neostigmine. Most studies agree that results are better when sugammadex is used.
Objectives: compare the capacity of sugammadex and neostigmine to revert vecuronium-induced neuromuscular blockade.
Methods: a case-control study was conducted to evaluate neuromuscular recovery with vecuronium after reversal with sugammadex and neostigmine. Muscular recovery was evaluated by clinical examination.
Results: a total 405 patients were studied. Group S was composed of 135 patients and Group N of 270. Mean surgical duration was 32.21±1.2 min for Group S and 33.16±1.2 min for Group N. Average reversal time was 2.2 min in Group S and 14.4 min in Group N. The quality of recovery was good in both groups. However, the frequency differences found in patients reverted with sugammadex were statistically significant (p = 0.00001). Complications were more frequent in Group N.
Conclusions: the capacity of sugammadex to revert vecuronium-induced neuromuscular blockade was confirmed. Reversal time was 6.54 longer with neostigmine. The quality of recovery was 1.34 times better with sugammadex. Adverse reactions were 11.02 times more frequent with neostigmine than with sugammadex.


REFERENCES

  1. Lunn J N, Hunter AN, Scott D. Anaesthesia related surgical mortality. Anaesthesia. 1983;38:1090-93.

  2. Suy K, Morias K,Cammu G, Hans P, van Duijnhoven WG, Heeringa M, Demeyer I. Effective reversal of moderate rocuronium or vecuronium induced neuromuscular block with sugammadex, a selective relaxant binding agent. Anesthesiology. 2007;106(2):283-8.

  3. Lemmens HJ, El-Orbany MI, Berry J, Morte JB Jr, Martin G. Reversal of profound vecuronium induced neuromuscular block under sevoflurane anesthesia: sugammadex versus neostigmina. BMC Anesthesiol. 2010;10(1):15.

  4. Mc Donagh DL, Benedict PE, Kovac AL, Drover DR, Brister NW, Morte JB, Monk TG. Efficacy, safety, and pharmacokinetics of sugammadex for the reversal of rocuroniuminduced neuromuscular blockade in elderly patients. Anesthesiology. 2011;114(2):318-29.

  5. Khuenl-Brady KS, Wattwil M, Vanacker BF, Lora-Tamayo JI, Rietbergen H, Alvarez- Gómez JA. Sugammadex provides faster reversal of vecuronium-induced neuromuscular blockade compared with neostigmine: a multicenter, randomized, controlled trial. Anesth Analg. 2010;110(1):64-73.

  6. Bridion. Ficha técnica European Agency for the Evaluation of Medicinal Products (EMEA). En línea. Consultada: [5/1/14]. URL disponible en http://www.ema.europa.eu/docs/es_ES/document_library/EPAR__Product_Informatio n/human/000885/WC500052310.pdf.

  7. Luque López E, Blasco Guerrero B, Horta Hernández. Sugammadex. Informe para la Comisión de Farmacia y Terapéutica del Hospital Universitario de Guadalajara 2009. En línea. [Consultada: 5/1/14]. URL disponible en http://www.gruposdetrabajo.sefh.es/genesis//Documents/Sugammadex_HUG_0709.pdf

  8. Karalapillai D, Kaufman M, Weinberg L. Sugammadex. Crit Care Resusc. 2013;15(1):57-62.

  9. Cordero Escobar I. Sugammadex. Nuevo reversor de los relajantes muscuares En: Los relajantes musculares en la clínica anestesiológica. Capítulo 21. Ciudad: Habana. ECIMED. 2010. pp 201-205.

  10. White PF, Tufanogullari B, Sacan O, Pavlin EG, Viegas OJ, Minkowitz HS, Hudson ME. The effect of residual neuromuscular blockade on the speed of reversal with sugammadex. Anesth & Analg. 2009;108(3):846-851.

  11. Pühringer FK, Rex C, Sielenkämper AW, Claudius C, Bo Larssen P, Prins ME, et al. Reversal of profound, high-dose rocuronium induced neuromuscular blockade by sugammadex at two different time points. Anesthesiology. 2008;109(2):188-97.

  12. Debaene B,Meistelman C. Indications and clinical use of sugammadex. Ann Fr Anesth Reanim. 2009;28 Suppl 2:S57-63.

  13. Lenz A, Hill G, White PF. Use of sugammadex after failure of standard reversal drugs. Anesthesia & Analgesia. 2007; 104(3): 585-586.

  14. Chambers D, Paulden M, Paton F, Heirs M, Duffy S, Craig D, Hunter J, Wilson J, Sculpher M, Woolacott N. Sugammadex for the reversal of muscle relaxation in general anaesthesia: a systematic review and economic assessment. Health Technol Assess. 2010;14(39):1-211.

  15. Veiga-Ruiz G, Domínguez N, Orozco J, Janda M, Hofmockel R, Alvarez-Gómez JA. Efficacy of sugammadex in the reversal of neuromuscular blockade induced by rocuronium in long-duration surgery: under inhaled vs. intravenous anaesthesia. Rev Esp Anestesiol Reanim. 2009; 56(6):349-54.

  16. Cordero Escobar I, Rey Martínez B, Company Teuler R, Pérez Carbonell A. Reversión del rocuronio con sugammadex en pacientes con procederes de larga duración. Presentación de dos casos. Rev Cubana Anest Rean 2011; 10 (2): En línea. [Consultado: 5/52011]. URL disponible en: http://bvs.sld.cu/revistas/scar/indice.html

  17. Fernández Meré LA, Alvarez-Blanco M. Sugammadex, a novel drug for neuromuscular blockade reversal. Rev Esp Anestesiol Reanim. 2010;57(2):95-102.

  18. Pühringer FK, Gordon M, Demeyer I, Sparr HJ, Ingimarsson J, Klarin B, van Duijnhoven W, Heeringa M. Sugammadex rapidly reverses moderate -rocuronium or vecuronium- induced neuromuscular block during sevoflurane anaesthesia: a doseresponse relationship. Br J Anaesth. 2010;105(5):610-9.

  19. Staals LM , van Egmond J, Driessen JJ, de Boer HD, van de Pol F, Bom AH, Booij LH. Sugammadex reverses neuromuscular block induced by 3-desacetyl-vecuronium, an active metabolite of vecuronium, in the anaesthetised rhesus monkey. Eur J Anaesthesiol. 2011;12(1):32-45.

  20. Schaller SJ, Fink H. Sugammadex as a reversal agent for neuromuscular block: an evidence-based review. Core Evid. 2013;8:57-67.

  21. Beny K, Mirabaud AF, Piriou V, Aulagner G, Armoiry X. Experience on the use of sugammadex in a French university hospital. Ann Fr Anesth Reanim. 2012;31(6):568-9.

  22. Watts RW, London JA, van Wijk RM, Lui YL. The influence of unrestricted use of sugammadex on clinical anaesthetic practice in a tertiary teaching hospital. Anaesth Intensive Care. 2012;40(2):333-9.

  23. Lien CA. Development and potential clinical impairment of ultra-short-acting neuromuscular blocking agents. Br J Anaesth. 2011;107 Suppl 1:60-71.

  24. Mosing M, Auer U, West E, Jones RS, Hunter JM. Reversal of profound rocuronium or vecuronium induced neuromuscular block with sugammadex in isofluraneanaesthetised dogs. Vet J. 2012;192(3):467-71.

  25. Duvaldestin P, Kuizenga K, Saldien V, Claudius C, Servin F, Klein J, Debaene B, Heeringa M. A randomized, dose-response study of sugammadex given for the reversal of deep rocuronium or vecuronium induced neuromuscular blockade under sevoflurane anesthesia. Anesth & Analg. 2010;110(1):74-82.

  26. Pühringer FK, Gordon M, Demeyer I, Sparr HJ, Ingimarsson J, Klarin B, van Duijnhoven W, Heeringa M. Sugammadex rapidly reverses moderate rocuronium- or vecuronium- induced neuromuscular block during sevoflurane anaesthesia: a doseresponse relationship. Br J Anaesth. 2010;105(5):610-9.

  27. Lemmens HJ, El-Orbany MI, Berry J, Morte JB Jr, Martin G. Reversal of profound vecuronium induced neuromuscular block under sevoflurane anesthesia: sugammadex versus neostigmine. BMC Anesthesiol. 2010;10:15.

  28. Makri I, Papadima A, Lafioniati A, Pappas AB, George K, Nikolaos KE, Ioannis CD, Charalambos S, Emmanuel LE, Xanthos T, Papadimitriou L. Sugammadex, a promising reversal drug. A review of clinical trials. Rev Recent Clin Trials. 2011;6(3):250-5.

  29. Glinka L, Onichimowski D, Sieniuta P, Korecki A. Sugammadex, two years in clinical practice. Anestezjol Intens Ter. 2010;42(3):155-9.

  30. Abrishami A, Ho J, Wong J, Yin L, Chung F. Cochrane corner: sugammadex, a selective reversal medication for preventing postoperative residual neuromuscular blockade. Anesth & Analg. 2010;110(4):1239.

  31. Mizikov VM, Stamov VI, Deshko IuV, Ialich AIu. Problem of neuromuscular block reversion: neostigmine and sugammadex. Anesteziol Reanimatol. 2010;(2):40-3.

  32. Paton F, Paulden M, Chambers D, Heirs M, Duffy S, Hunter JM, Sculpher M, Woolacott N. Sugammadex compared with neostigmine/glycopyrrolate for routine reversal of neuromuscular block: a systematic review and economic evaluation. Br J Anaesth. 2010;105(5):558-67.

  33. Geldner G, Niskanen M, Laurila P, Mizikov V, Hübler M, Beck G, Rietbergen H, Nicolayenko E. A randomised controlled trial comparing sugammadex and neostigmine at different depths of neuromuscular blockade in patients undergoing laparoscopic surgery. Anaesthesia. 2012;67(9):991-8.

  34. Paton F, Paulden M, Chambers D, Heirs M, Duffy S, Hunter JM, Sculpher M, Woolacott N. Sugammadex compared with neostigmine/glycopyrrolate for routine reversal of neuromuscular block: a systematic review and economic evaluation. Br J Anaesth. 2010;105(5):558-67.

  35. Barbosa FT, da Cunha RM. Reversal of profound neuromuscular blockade with sugammadex after failure of rapid sequence endotracheal intubation: a case report. Rev Bras Anestesiol. 2012;62(2):281-4.

  36. Salas Ballestín A, de Carlos Vicente JC, Clavero Rubio C, Miralles Morell F. Extubation failure due to prolonged residual block vecuronium. Treatment with sugammadex. An Pediatr (Barc). 2013;(13): S1695-4033.

  37. Peeters P, Passier P, Smeets J, Zwiers A, de Zwart M, van de Wetering-Krebbers S, van Iersel M, van Marle S, van den Dobbelsteen D. Sugammadex is cleared rapidly and primarily unchanged via renal excretion. Biopharm Drug Dispos. 2011;32(3):159-67.

  38. Zwiers A, van den Heuvel M, Smeets J, Rutherford S. Assessment of the potential for displacement interactions with sugammadex: a pharmacokineticpharmacodynamic modelling approach. Clin Drug Investig. 2011;31(2):101-11.

  39. Kam PJ, Heuvel MW, Grobara P, Zwiers A, Jadoul JL, Clerck Ed, Ramael S, Peeters PA. Flucloxacillin and diclofenac do not cause recurrence of neuromuscular blockade after reversal with sugammadex. Clin Drug Investig. 2012;32(3):203-12.

  40. Ohshita N, Tsutsumi YM, Kasai A, Soga T, Kanamura T, Katayama T, Iseki A, Tomiyama Y, Tanaka K. Two cases of anaphylactoid reaction after administration of sugammadex. Masui 2012;61(11):1261-4. de Kam PJ, van Kuijk J, Prohn M, Thomsen T, Peeters P. Effects of sugammadex doses up to 32 mg/kg alone or in combination with rocuronium or vecuronium on QTc prolongation: a thorough QTc study. Clin Drug Investig. 2010;30(9):599-611.

  41. Fuchs-Buder T, Meistelman C, Schreiber JU. Is sugammadex economically viable for routine use. Curr Opin Anaesthesiol. 2012;25(2):217-20.

  42. Aho AJ, Kamata K, Yli-Hankala A, Lyytikäinen LP, Kulkas A, Jäntti V. Elevated BIS and Entropy values after sugammadex or neostigmine: an electroencephalographic or electromyographic phenomenon? Acta Anaesthesiol Scand. 2012;56(4):465-73.




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