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Reversal of rocuronium induced neuromuscular block with sugammadex or neostigmine: a large observational study.
Acta Anaesthesiol Scand. 2013 Oct; 57(9):1138-45.AA

Abstract

BACKGROUND

This 'real-life' study aimed to analyze the time from the start of neostigmine or sugammadex administration to recovery to a train of four ratio (TOFr) of 0.9 in a real-life in patients receiving rocuronium. The secondary aims were to assess the proportion of patients: presenting TOFr < 0.9 after 5, 10, and 20 min from reversal agent administration, receiving opioids for intraoperative analgesia and extubated in the post-anesthesia care unit (PACU).

METHODS

This was a multisite, prospective, nonrandomized, observational real-life study. Reversal agent was administered at either T2 reappearance or at a post-tetanic count of 1 or 2. Drugs dosages were free according to each investigator's usual practice.

RESULTS

Three hundred fifty-nine patients were enrolled onto the study. Time from reversal administration to TOFr to 0.9 is significantly faster in the sugammadex group than in the neostigmine group (shallow block: 2.2 vs. 6.9 min, respectively; P < 0.0001; deep block: 2.7 vs. 16.2 min, respectively; P < 0.0001). The number of patients with TOFr < 0.9 at 5, 10, and 20 min post-reversal agent administration was higher in the neostigmine than in the sugammadex group. Just five patients did not receive opioids. All patients were extubated in the operative room except for a single patient in the sugammadex group who was extubated following PACU admission.

CONCLUSIONS

This real-life study confirms that reversal time is faster in patients receiving sugammadex than in those receiving neostigmine. TOFr < 0.9 20 min after reversal was only present in patients treated with neostigmine.

Authors+Show Affiliations

Department of Anesthesia and Intensive Care Medicine, AOU Santa Maria della Misericordia - University of Udine, Udine, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo 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
Observational Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23849107

Citation

Della Rocca, G, et al. "Reversal of Rocuronium Induced Neuromuscular Block With Sugammadex or Neostigmine: a Large Observational Study." Acta Anaesthesiologica Scandinavica, vol. 57, no. 9, 2013, pp. 1138-45.
Della Rocca G, Pompei L, Pagan DE Paganis C, et al. Reversal of rocuronium induced neuromuscular block with sugammadex or neostigmine: a large observational study. Acta Anaesthesiol Scand. 2013;57(9):1138-45.
Della Rocca, G., Pompei, L., Pagan DE Paganis, C., Tesoro, S., Mendola, C., Boninsegni, P., Tempia, A., Manstretta, S., Zamidei, L., Gratarola, A., Murabito, P., Fuggiano, L., & DI Marco, P. (2013). Reversal of rocuronium induced neuromuscular block with sugammadex or neostigmine: a large observational study. Acta Anaesthesiologica Scandinavica, 57(9), 1138-45. https://doi.org/10.1111/aas.12155
Della Rocca G, et al. Reversal of Rocuronium Induced Neuromuscular Block With Sugammadex or Neostigmine: a Large Observational Study. Acta Anaesthesiol Scand. 2013;57(9):1138-45. PubMed PMID: 23849107.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reversal of rocuronium induced neuromuscular block with sugammadex or neostigmine: a large observational study. AU - Della Rocca,G, AU - Pompei,L, AU - Pagan DE Paganis,C, AU - Tesoro,S, AU - Mendola,C, AU - Boninsegni,P, AU - Tempia,A, AU - Manstretta,S, AU - Zamidei,L, AU - Gratarola,A, AU - Murabito,P, AU - Fuggiano,L, AU - DI Marco,P, Y1 - 2013/07/14/ PY - 2013/06/17/accepted PY - 2013/7/16/entrez PY - 2013/7/16/pubmed PY - 2014/4/12/medline SP - 1138 EP - 45 JF - Acta anaesthesiologica Scandinavica JO - Acta Anaesthesiol Scand VL - 57 IS - 9 N2 - BACKGROUND: This 'real-life' study aimed to analyze the time from the start of neostigmine or sugammadex administration to recovery to a train of four ratio (TOFr) of 0.9 in a real-life in patients receiving rocuronium. The secondary aims were to assess the proportion of patients: presenting TOFr < 0.9 after 5, 10, and 20 min from reversal agent administration, receiving opioids for intraoperative analgesia and extubated in the post-anesthesia care unit (PACU). METHODS: This was a multisite, prospective, nonrandomized, observational real-life study. Reversal agent was administered at either T2 reappearance or at a post-tetanic count of 1 or 2. Drugs dosages were free according to each investigator's usual practice. RESULTS: Three hundred fifty-nine patients were enrolled onto the study. Time from reversal administration to TOFr to 0.9 is significantly faster in the sugammadex group than in the neostigmine group (shallow block: 2.2 vs. 6.9 min, respectively; P < 0.0001; deep block: 2.7 vs. 16.2 min, respectively; P < 0.0001). The number of patients with TOFr < 0.9 at 5, 10, and 20 min post-reversal agent administration was higher in the neostigmine than in the sugammadex group. Just five patients did not receive opioids. All patients were extubated in the operative room except for a single patient in the sugammadex group who was extubated following PACU admission. CONCLUSIONS: This real-life study confirms that reversal time is faster in patients receiving sugammadex than in those receiving neostigmine. TOFr < 0.9 20 min after reversal was only present in patients treated with neostigmine. SN - 1399-6576 UR - https://www.unboundmedicine.com/medline/citation/23849107/Reversal_of_rocuronium_induced_neuromuscular_block_with_sugammadex_or_neostigmine:_a_large_observational_study_ L2 - https://doi.org/10.1111/aas.12155 DB - PRIME DP - Unbound Medicine ER -