Reversibility of Rocuronium-Induced Deep Neuromuscular Block with Sugammadex in Infants and Children - A Randomized Study
Sugammadex 4mg・kg-1 is recommended for reversal from rocuronium-induced deep neuromuscular block. However, there is limited data regarding the dose-response of sugammadex required for reversal from deep neuromuscular block in pediatric patients. The aim of this study was to determine the reversibili...
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| Published in: | Biological and Pharmaceutical Bulletin Vol. 42; no. 10; pp. 1637 - 1640 |
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| Main Authors: | , , , , , |
| Format: | Journal Article |
| Language: | Japanese |
| Published: |
Pharmaceutical Society of Japan
01-10-2019
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| Online Access: | Get full text |
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| Summary: | Sugammadex 4mg・kg-1 is recommended for reversal from rocuronium-induced deep neuromuscular block. However, there is limited data regarding the dose-response of sugammadex required for reversal from deep neuromuscular block in pediatric patients. The aim of this study was to determine the reversibility of rocuronium-induced deep neuromuscular block with sugammadex in infants and children. Seventy-five children (48 infants and 27 children, mean standard deviation (S.D.), age: 11.6 (6.7) months) were enrolled in this study. After induction of anesthesia and administration of 0.6 mg・kg-1 rocuronium, neuromuscular block was acceleromyographically evaluated by observing contractions of the adductor pollicis muscle to ulnar nerve train-of-four (TOF) stimulation. Subsequently, the intensity of rocuronium-induced block was determined every 6 min using post-tetanic count (PTC) stimulation during sevoflurane and remifentanil anesthesia. When the first response to the PTC stimulus was detected, either 1, 2 or 4mg・kg-1 sugammadex was administered and the time required for facilitated recovery to a TOF ratio of 0.9 following each dose was compared. The time [mean (S.D.)] from the administration of 1 mg・kg-1 sugammadex until recovery to a TOF ratio of 0.9 was significantly longer [129.1 (83.5)s, p<0.001] than that with 2 and 4 mg・kg-1 sugammadex [70.3 (26.7)s and 68.2 (34.5)s, respectively]. Incomplete reversal was seen in 3 patients in the 1 mg・kg-1 group. The results suggested that a 4mg・kg-1 sugammadex dose is recommended for reversal from rocuronium-induced deep neuromuscular block even in infants and children. |
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| ISSN: | 0918-6158 |