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A randomised controlled trial comparing sugammadex and neostigmine at different depths of neuromuscular blockade in patients undergoing laparoscopic surgery.
Anaesthesia. 2012 Sep; 67(9):991-8.A

Abstract

Deep neuromuscular blockade during certain surgical procedures may improve operating conditions. Sugammadex can be used to reverse deep neuromuscular blockade without waiting for spontaneous recovery. This randomised study compared recovery times from neuromuscular blockade induced by rocuronium 0.6 mg.kg(-1), using sugammadex 4 mg.kg(-1) administered at 1-2 post-tetanic count (deep blockade) or neostigmine 50 μg.kg(-1) (plus atropine 10 μg.kg(-1)) administered at the re-appearance of the second twitch of a train-of-four stimulation (moderate blockade), in patients undergoing laparoscopic surgery. The primary efficacy variable was the time from the start of sugammadex/neostigmine administration to recovery of the train-of-four ratio to 0.9. Patients receiving sugammadex recovered 3.4 times faster than patients receiving neostigmine (geometric mean (95% CI) recovery times of 2.4 (2.1-2.7) and 8.4 (7.2-9.8) min, respectively, p<0.0001). Moreover, 94% (62/66) of sugammadex-treated patients recovered within 5 min, vs 20% (13/65) of neostigmine-treated patients, despite the difference in the depth of neuromuscular blockade at the time of administration of both drugs. The ability to provide deep neuromuscular blockade throughout the procedure but still permit reversal at the end of surgery may enable improved surgical access and an enhanced visual field.

Authors+Show Affiliations

Department of Anaesthesiology, Klinikum Ludwigsburg, Academic Teaching Hospital, University of Heidelberg, Ludwigsburg, Germany. goetz.geldner@kliniken-lb.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22698066

Citation

Geldner, G, et al. "A Randomised Controlled Trial Comparing Sugammadex and Neostigmine at Different Depths of Neuromuscular Blockade in Patients Undergoing Laparoscopic Surgery." Anaesthesia, vol. 67, no. 9, 2012, pp. 991-8.
Geldner G, Niskanen M, Laurila P, et al. 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.
Geldner, G., Niskanen, M., Laurila, P., Mizikov, V., Hübler, M., Beck, G., Rietbergen, H., & Nicolayenko, E. (2012). A randomised controlled trial comparing sugammadex and neostigmine at different depths of neuromuscular blockade in patients undergoing laparoscopic surgery. Anaesthesia, 67(9), 991-8. https://doi.org/10.1111/j.1365-2044.2012.07197.x
Geldner G, et al. 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. PubMed PMID: 22698066.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A randomised controlled trial comparing sugammadex and neostigmine at different depths of neuromuscular blockade in patients undergoing laparoscopic surgery. AU - Geldner,G, AU - Niskanen,M, AU - Laurila,P, AU - Mizikov,V, AU - Hübler,M, AU - Beck,G, AU - Rietbergen,H, AU - Nicolayenko,E, Y1 - 2012/06/14/ PY - 2012/6/16/entrez PY - 2012/6/16/pubmed PY - 2012/10/12/medline SP - 991 EP - 8 JF - Anaesthesia JO - Anaesthesia VL - 67 IS - 9 N2 - Deep neuromuscular blockade during certain surgical procedures may improve operating conditions. Sugammadex can be used to reverse deep neuromuscular blockade without waiting for spontaneous recovery. This randomised study compared recovery times from neuromuscular blockade induced by rocuronium 0.6 mg.kg(-1), using sugammadex 4 mg.kg(-1) administered at 1-2 post-tetanic count (deep blockade) or neostigmine 50 μg.kg(-1) (plus atropine 10 μg.kg(-1)) administered at the re-appearance of the second twitch of a train-of-four stimulation (moderate blockade), in patients undergoing laparoscopic surgery. The primary efficacy variable was the time from the start of sugammadex/neostigmine administration to recovery of the train-of-four ratio to 0.9. Patients receiving sugammadex recovered 3.4 times faster than patients receiving neostigmine (geometric mean (95% CI) recovery times of 2.4 (2.1-2.7) and 8.4 (7.2-9.8) min, respectively, p<0.0001). Moreover, 94% (62/66) of sugammadex-treated patients recovered within 5 min, vs 20% (13/65) of neostigmine-treated patients, despite the difference in the depth of neuromuscular blockade at the time of administration of both drugs. The ability to provide deep neuromuscular blockade throughout the procedure but still permit reversal at the end of surgery may enable improved surgical access and an enhanced visual field. SN - 1365-2044 UR - https://www.unboundmedicine.com/medline/citation/22698066/A_randomised_controlled_trial_comparing_sugammadex_and_neostigmine_at_different_depths_of_neuromuscular_blockade_in_patients_undergoing_laparoscopic_surgery_ L2 - https://doi.org/10.1111/j.1365-2044.2012.07197.x DB - PRIME DP - Unbound Medicine ER -