[Sugammadex--a new era in the antagonsim of muscle relaxants].
Cyclodextrins consist of rings of sugar molecules with a lipophilic core and a hydrophilic periphery. Thus they are well soluble in water and possess the ability to bind (encapsulate) steroid molecules. Cyclodextrins have now been modified (sugammadex) in such a way a perfect complex formation with rocuronium results. In this way an alternative to the classical indirect antagonists has been discovered. It is now possible to terminate a neuromuscular blockade via an intravasal encapsulation of rocuronium far distant from the neuromuscular endplates and avoiding the side effects associated with acetylcholinestase inhibitors instead of by an intervention in the acetylcholine system. Furthermore, it has been found that even deep neuromuscular blockades can be reversed within 2 minutes by means of this novel mechanism.
Rex
Christopher
C
Klinik für Anästhesiologie und operative Intensivmedizin am Klinikum am Steinenberg, Reutlingen. rex_c@klin-rt.de
Pühringer
Friedrich K
FK
D000732:Androstanols / Q000737:chemistry / Q000627:therapeutic use; D006801:Humans; D007668:Kidney / Q000187:drug effects / Q000502:physiology; D008958:Models, Molecular; D009126:Muscle Relaxation / Q000187:drug effects / Q000502:physiology; D009466:Neuromuscular Blocking Agents / Q000037:antagonists & inhibitors*; D003473:Neuromuscular Nondepolarizing Agents / Q000737:chemistry; D000077123:Rocuronium; D000077122:Sugammadex; D047408:gamma-Cyclodextrins / Q000737:chemistry / Q000627:therapeutic use*
D000732:Androstanols; D009466:Neuromuscular Blocking Agents; D003473:Neuromuscular Nondepolarizing Agents; D047408:gamma-Cyclodextrins; D000077122:Sugammadex; D000077123:Rocuronium