title: Efficacy of different doses of sugammadex after continuous infusion of rocuronium.
abstract: OBJECTIVE
  To evaluate the effects of two different doses of sugammadex after maintenance anesthesia with sevofluorane and remifentanil and deep rocuronium-induced neuromuscular blockade (NMB).
  
  
  METHODS
  Patients between 20 and 65 years of age, with American Society of Anesthesiologists physical status classification I-II, undergoing gynecological surgery were included in a prospective, comparative and randomized study. NMB was induced with an injection of 0.6 mg/kg of rocuronium followed by continuous infusion of 0.3-0.6 mg/kg per hour to maintain a deep block. Anesthesia was maintained with sevofluorane and remifentanil. Finally, when surgery was finished, a bolus of 2 mg/kg (group A) or 4 mg/kg (group B) of sugammadex was applied when the NMB first response in the train-of-four was reached. The primary clinical endpoint was time to recovery to a train-of-four ratio of 0.9. Other variables recorded were the time until recovery of train-of-four ratio of 0.7, 0.8, hemodynamic variables (arterial blood pressure and heart rate at baseline, starting sugammadex, and minutes 2, 5 and 10) and adverse events were presented after one hour in the post-anesthesia care unit.
  
  
  RESULTS
  Thirty-two patients were included in the study: 16 patients in group A and 16 patients in group B. Only 14 patients each group were recorded because arterial pressure values were lost in two patients from each group in minute 10. The two groups were comparable. Median recovery time from starting of sugammadex administration to a train-of-four ratio of 0.9 in group A and B was 129 and 110 s, respectively. The estimated difference in recovery time between groups was 24 s (95%CI: 0 to 45 s, Hodges-Lehmann estimator), entirely within the predefined equivalence interval. Times to recovery to train-of-four ratios of 0.8 (group A: 101 s; group B: 82.5 s) and 0.7 (group A: 90 s; group B: 65 s) from start of sugammadex administration were not equivalent between groups. There was not a significant variation in the arterial pressure and heart rate values between the two groups and none of the patients showed any clinical evidence of residual or recurrent NMB.
  
  
  CONCLUSIONS
  A dose of 2 mg/kg of sugammadex after continuous rocuronium infusion is enough to reverse the NMB when first response in the Train-Of-Four is reached.
authors: Diego Soto Mesa, Mounir Fayad Fayad, Laura Pérez Arviza, Verónica Del Valle Ruiz, Fernando Cosío Carreño, Luis Arguelles Tamargo, Department of Anaesthesiology, Hospital of Cabueñes, 33394 Gijón, Spain.
authors: Diego
authors: D
authors: Soto Mesa
authors: Diego Soto Mesa, Mounir Fayad Fayad, Laura Pérez Arviza, Verónica Del Valle Ruiz, Fernando Cosío Carreño, Luis Arguelles Tamargo, Department of Anaesthesiology, Hospital of Cabueñes, 33394 Gijón, Spain.
authors: Mounir
authors: M
authors: Fayad Fayad
authors: Diego Soto Mesa, Mounir Fayad Fayad, Laura Pérez Arviza, Verónica Del Valle Ruiz, Fernando Cosío Carreño, Luis Arguelles Tamargo, Department of Anaesthesiology, Hospital of Cabueñes, 33394 Gijón, Spain.
authors: Laura
authors: L
authors: Pérez Arviza
authors: Diego Soto Mesa, Mounir Fayad Fayad, Laura Pérez Arviza, Verónica Del Valle Ruiz, Fernando Cosío Carreño, Luis Arguelles Tamargo, Department of Anaesthesiology, Hospital of Cabueñes, 33394 Gijón, Spain.
authors: Verónica
authors: V
authors: Del Valle Ruiz
authors: Diego Soto Mesa, Mounir Fayad Fayad, Laura Pérez Arviza, Verónica Del Valle Ruiz, Fernando Cosío Carreño, Luis Arguelles Tamargo, Department of Anaesthesiology, Hospital of Cabueñes, 33394 Gijón, Spain.
authors: Fernando
authors: F
authors: Cosío Carreño
authors: Diego Soto Mesa, Mounir Fayad Fayad, Laura Pérez Arviza, Verónica Del Valle Ruiz, Fernando Cosío Carreño, Luis Arguelles Tamargo, Department of Anaesthesiology, Hospital of Cabueñes, 33394 Gijón, Spain.
authors: Luis
authors: L
authors: Arguelles Tamargo
authors: Diego Soto Mesa, Mounir Fayad Fayad, Laura Pérez Arviza, Verónica Del Valle Ruiz, Fernando Cosío Carreño, Luis Arguelles Tamargo, Department of Anaesthesiology, Hospital of Cabueñes, 33394 Gijón, Spain.
authors: Manuel
authors: M
authors: Amorín Díaz
authors: Diego Soto Mesa, Mounir Fayad Fayad, Laura Pérez Arviza, Verónica Del Valle Ruiz, Fernando Cosío Carreño, Luis Arguelles Tamargo, Department of Anaesthesiology, Hospital of Cabueñes, 33394 Gijón, Spain.
authors: Sergio
authors: S
authors: Fernández-Pello Montes
keywords: Monitoring neuromuscular function; Neuromuscular block antagonism; Neuromuscular block rocuronium; Rocuronium; Sugammadex