Immediate rescue reversal of rocuronium-induced intense neuromuscular blockade using sugammadex in pediatric surgical patients.
- Author:
Joanne C. Altamera-Remedios
;
Pamela Joy G. Lim-Lopez
;
Janette T. Fusilero-Pascual
;
Teresita A. Batanes
- Publication Type:Journal Article
- Keywords:
Sugammadex;
Immediate Rescue Reversal;
Intense Neuromuscular Blockade
- From:
The Philippine Children’s Medical Center Journal
2019;15(1):16-30
- CountryPhilippines
- Language:English
-
Abstract:
BACKGROUND:The dose of Sugammadex for rescue reversal of intense neuromuscular block has not
been studied in children. The only recommended dose of Sugammadex in children is 2mg/kg to reverse a shallow block.
OBJECTIVES:To assess the efficacy and safety of Sugammadex 2mg/kg and 4mg/kg as immediate
rescue reversal of intense rocuronium-induced neuromuscular block in pediatric patients
METHODS:80 children, aged 2 to 11 years old, requiring general anesthesia were enrolled in this randomized prospective study. Group 1 given Sugammadex 2mg/kg (40 subjects) while Group 2 received Sugammadex 4mg/kg (40 subjects), at the end of the procedure if PTC=0. The Recovery Time was recorded (TOF ratio ≥0.9) (Primary Outcome). Discharge readiness in the PACU was assessed using
Modified Aldrete Scale (Secondary Outcome). Monitoring of adverse effects in the ward continued until
24 hours postoperatively.
RESULTS:There were significantly more patients in the Sugammadex 4mg/kg that had a recovery time
of ≤2min as compared to those given Sugammadex 2mg/kg (p=0.012). There was no significant
difference in the Aldrete score between the two groups (p=0.2776). All patients achieved a very
satisfactory discharge score in the PACU. The adverse effects experienced by the patients in the two
doses of Sugammadex in the PACU and up to 24 hours postoperatively were not significantly different.
CONCLUSION:Sugammadex 4mg/kg can be considered safe and effective as an immediate reversal
agent for rocuronium-induced intense neuromuscular blockade in children.
RECOMMENDATIONS:Clinicians should identify if Sugammadex 6mg/kg, compared with 4mg/kg,
would translate to a shorter Recovery time to a TOF ratio of 0.9. The time from TOF ratio of 0.9 to the
time of extubation should be measured to increase the efficacy and safety assessment of Sugammadex in this age group.
- Full text:Immediate rescue reversal of.pdf
