Sugammadex: a selective relaxant-binding agent providing rapid reversal.
OBJECTIVE
Sugammadex is a new reversal agent with a unique mechanism of action in anaesthesia. Because of its rapid onset of action and its efficacy in determining neuromuscular blockade at any time, it opens up new perspectives in anaesthesia.


RESULTS
During the last few years, a lot of phase II and III studies have been published, investigating various groups of patients and clinical situations. Sugammadex has been shown to be a well tolerated drug, which appears to meet every challenge it is presented with in daily clinical practice.


CONCLUSIONS
Sugammadex binds amino-steroidal muscle relaxants by encapsulation. It enables rapid reversal of neuromuscular blockade at any time point and at any depth of block. Its effects are predictable and very reliable, in contrast to cholinesterase inhibitors. This opens up new perspectives in anaesthesia. Even an emergency reversal of high-dose rocuronium-induced neuromuscular blockade is possible with sugammadex and times to full recovery (TOF 0.9) are faster than after spontaneous recovery from suxamethonium.
Rex
Christopher
C
Department for Anaesthesia and Intensive Care Medicine, Klinikum am Steinenberg, Academic Hospital of the University of Tübingen, Reutlingen, Germany.
Bergner
Urs A
UA
Pühringer
Friedrich K
FK
D000732:Androstanols / Q000037:antagonists & inhibitors; D000758:Anesthesia; D000818:Animals; D004347:Drug Interactions; D004632:Emergency Medical Services; D006801:Humans; D009125:Muscle Relaxants, Central / Q000037:antagonists & inhibitors*; D003473:Neuromuscular Nondepolarizing Agents / Q000037:antagonists & inhibitors; D000077123:Rocuronium; D000077122:Sugammadex; D014673:Vecuronium Bromide / Q000037:antagonists & inhibitors; D047408:gamma-Cyclodextrins / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology*
D000732:Androstanols; D009125:Muscle Relaxants, Central; D003473:Neuromuscular Nondepolarizing Agents; D047408:gamma-Cyclodextrins; D000077122:Sugammadex; D014673:Vecuronium Bromide; D000077123:Rocuronium