title: Sugammadex versus neostigmine reversal of moderate rocuronium-induced neuromuscular blockade in Korean patients.
abstract: BACKGROUND
  Rapid and complete reversal of neuromuscular blockade (NMB) is desirable at the end of surgery. Sugammadex reverses rocuronium-induced NMB by encapsulation. It is well tolerated in Caucasian patients, providing rapid reversal of moderate (reappearance of T2) rocuronium-induced NMB. We investigated the efficacy and safety of sugammadex versus neostigmine in Korean patients.
  
  
  METHODS
  This randomized, safety assessor-blinded trial (NCT01050543) included Korean patients undergoing general anesthesia. Rocuronium 0.6 mg/kg was given prior to intubation with maintenance doses of 0.1-0.2 mg/kg as required. Patients received sugammadex 2.0 mg/kg or neostigmine 50 µg/kg with glycopyrrolate 10 µg/kg to reverse the NMB at the reappearance of T2, after the last rocuronium dose. The primary efficacy endpoint was the time from sugammadex or neostigmine administration to recovery of the train-of-four (TOF) ratio to 0.9. The safety of these medications was also assessed.
  
  
  RESULTS
  Of 128 randomized patients, 118 had evaluable data (n = 59 in each group). The geometric mean (95% confidence interval) time to recovery of the TOF ratio to 0.9 was 1.8 (1.6, 2.0) minutes in the sugammadex group and 14.8 (12.4, 17.6) minutes in the neostigmine group (P < 0.0001). Sugammadex was generally well tolerated, with no evidence of residual or recurrence of NMB; four patients in the neostigmine group reported adverse events possibly indicative of inadequate NMB reversal.
  
  
  CONCLUSIONS
  Sugammadex was well tolerated and provided rapid reversal of moderate rocuronium-induced NMB in Korean patients, with a recovery time 8.1 times faster than neostigmine. These results are consistent with those reported for Caucasian patients.
authors.affiliation: Clinical Development, Merck Sharp & Dohme Corp., Whitehouse Station, NJ, USA.
authors.forename: Tiffany
authors.initials: T
authors.lastname: Woo
authors.affiliation: Department of Anesthesiology and Pain Medicine, College of Medicine, Hanyang University, Seoul, Korea.
authors.forename: Kyo Sang
authors.initials: KS
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Yon Hee
authors.initials: YH
authors.lastname: Shim
authors.affiliation: Department of Anesthesiology and Pain Medicine, College of Medicine, Kyung Hee University Hospital, Seoul, Korea.
authors.forename: Mi Kyeong
authors.initials: MK
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology and Pain Medicine, Korea University Anam Hospital, Seoul, Korea.
authors.forename: Suk Min
authors.initials: SM
authors.lastname: Yoon
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Young Jin
authors.initials: YJ
authors.lastname: Lim
authors.affiliation: Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Hong Seuk
authors.initials: HS
authors.lastname: Yang
authors.affiliation: Clinical Development, Merck Sharp & Dohme Corp., Whitehouse Station, NJ, USA.
authors.forename: Phillip
authors.initials: P
authors.lastname: Phiri
authors.affiliation: Department of Anesthesiology and Pain Medicine, The Catholic University of Korea, School of Medicine, St. Mary's Hospital, Seoul, Korea.
authors.forename: Jin Young
authors.initials: JY
authors.lastname: Chon
keywords: Caucasian; Korean; Neostigmine; Neuromuscular blockade; Rocuronium; Sugammadex