title: Prediction of optimal reversal dose of sugammadex after rocuronium administration in adult surgical patients.
abstract: The objective of this study was to determine the point after sugammadex administration at which sufficient or insufficient dose could be determined, using first twitch height of train-of-four (T1 height) or train-of-four ratio (TOFR) as indicators. Groups A and B received 1 mg/kg and 0.5 mg/kg of sugammadex, respectively, as a first dose when the second twitch reappeared in train-of-four stimulation, and Groups C and D received 1 mg/kg and 0.5 mg/kg of sugammadex, respectively, as the first dose at posttetanic counts 1-3. Five minutes after the first dose, an additional 1 mg/kg of sugammadex was administered and changes in T1 height and TOFR were observed. Patients were divided into a recovered group and a partly recovered group, based on percentage changes in T1 height after additional dosing. T1 height and TOFR during the 5 min after first dose were then compared. In the recovered group, TOFR exceeded 90% in all patients at 3 min after sugammadex administration. In the partly recovered group, none of the patients had a TOFR above 90% at 3 min after sugammadex administration. An additional dose of sugammadex can be considered unnecessary if the train-of-four ratio is ≥90% at 3 min after sugammadex administration. This trial is registered with UMIN000007245.
authors.affiliation: Department of Anesthesiology and Critical Care, Asahikawa Medical University, 2-1-1-1 Midorigaoka-higashi, Asahikawa, Hokkaido 078-8510, Japan.
authors.forename: Shigeaki
authors.identifier: 0000-0002-0696-3508
authors.initials: S
authors.lastname: Otomo
authors.affiliation: Department of Anesthesiology and Critical Care, Asahikawa Medical University, 2-1-1-1 Midorigaoka-higashi, Asahikawa, Hokkaido 078-8510, Japan.
authors.forename: Hajime
authors.identifier: 0000-0002-6288-7706
authors.initials: H
authors.lastname: Iwasaki
authors.affiliation: Department of Anesthesiology and Critical Care, Asahikawa Medical University, 2-1-1-1 Midorigaoka-higashi, Asahikawa, Hokkaido 078-8510, Japan.
authors.forename: Kenichi
authors.identifier: 0000-0001-8735-2452
authors.initials: K
authors.lastname: Takahoko
authors.affiliation: Department of Anesthesiology and Critical Care, Asahikawa Medical University, 2-1-1-1 Midorigaoka-higashi, Asahikawa, Hokkaido 078-8510, Japan.
authors.forename: Yoshiko
authors.identifier: 0000-0001-7061-4217
authors.initials: Y
authors.lastname: Onodera
authors.affiliation: Department of Anesthesiology and Critical Care, Asahikawa Medical University, 2-1-1-1 Midorigaoka-higashi, Asahikawa, Hokkaido 078-8510, Japan.
authors.forename: Tomoki
authors.identifier: 0000-0001-7465-2616
authors.initials: T
authors.lastname: Sasakawa
authors.affiliation: Department of Anesthesiology and Critical Care, Asahikawa Medical University, 2-1-1-1 Midorigaoka-higashi, Asahikawa, Hokkaido 078-8510, Japan.
authors.forename: Takayuki
authors.identifier: 0000-0001-8669-8283
authors.initials: T
authors.lastname: Kunisawa
authors.affiliation: Department of Anesthesiology and Critical Care, Asahikawa Medical University, 2-1-1-1 Midorigaoka-higashi, Asahikawa, Hokkaido 078-8510, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Iwasaki