Sugammadex: a selective relaxant binding agent for reversal of neuromuscular block.
Neostigmine, the currently used agent for reversal of neuromuscular block, has several drawbacks, such as a slow onset of peak effect, inability to reverse deep block and the occurrence of widespread muscarinic effects. Sugammadex is a new class of reversal agent that acts by encapsulating the molecules of the relaxants rocuronium and vecuronium, for which it is a specific antagonist. Clinical trials in over 2000 subjects have shown it to be effective for reversal of block by these two relaxants even from deep levels, in doses of 2.0-4.0 mg/kg. Sugammadex can also reverse an intense (profound) high-dose rocuronium block, but the dose required in this situation is 16.0 mg/kg. The agent has been found to be safe so far, with few side effects.
Hogg
Rosemary M G
RM
Department of Anaesthetics and ICM, Queen's University, Belfast, UK.
Mirakhur
Rajinder K
RK
D000818:Animals; D002986:Clinical Trials as Topic; D003505:Cyclodextrins / Q000737:chemistry / Q000627:therapeutic use*; D006801:Humans; D019148:Neuromuscular Blockade / Q000379:methods*; D009468:Neuromuscular Diseases / Q000188:drug therapy*; D009469:Neuromuscular Junction / Q000502:physiology; D003473:Neuromuscular Nondepolarizing Agents / Q000037:antagonists & inhibitors*; D000077122:Sugammadex; D047408:gamma-Cyclodextrins / Q000737:chemistry / Q000627:therapeutic use*
D003505:Cyclodextrins; D003473:Neuromuscular Nondepolarizing Agents; D047408:gamma-Cyclodextrins; D000077122:Sugammadex