7ème journée de la recherche clinique : efficacy of sugammadex
DESCRIPTION
Efficacy of Sugammadex for the Reversal of Moderate and Deep Rocuronium-induced Neuromuscular Block in Patients pretreated with Intravenous Magnesium de C. Czarnetzki lors de la 7ème Journée de la Recherche Clinique aux HUGTRANSCRIPT
Division of Anesthesiology, Geneva University Hospitals, Geneva, Switzerland (CC, CL, NE, MRT)Faculty of Medicine, University of Geneva, Geneva, Switzerland (MRT)
Department of Anesthesiology and Intensive Care, University of Debrecen, Debrecen, Hungary (ET)Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland (NE.
Neuromuscular endplate Neuromuscular monitoring: TOF Watch
Neuromuscular monitoring: Single twitch and Train-of-Four stimulation
Neuromuscular transmission
Sugammadex antagonises Rocuronium through
encapsulation
Rocuronium Sugammadex Encapsulation
Magnesium is frequently used in daily clinical practice:obstetrics, cardiology, intensive care, anaesthesiology
Magnesium interacts with neuromuscular transmission
Magnesium and neuromuscular transmission
Czarnetzki et al. Acta Anaesthesiol Scand 2010:54:299-306
To investigate whether magnesium decreases the efficacy of sugammadex for the reversal of rocuronium-induced neuromuscular block
Aim of the study
Hans et al. Eur J Anaesthesiol 2010; X: YYY-YYY
Vulnerability of the neuromuscular transmission after normalisation to TOF 0.9
Study design
Moderate block = 2 twitches
Deep block = Post-tetanic count 2
Results (I): Reversal of moderate block
Results (I): Reversal of deep block
The efficacy of recommended doses of sugammadex for the reversal of moderate and deep rocuronium-induced block is preserved despite the administration of a single IV infusion of magnesium.
Conclusions
Recommended doses of sugammadex allow for encapsulating the majority of rocuronium molecules that are present at the neuromuscular junction.
Sugammadex, within the recommended dose regimens, not only antagonizes the neuromuscular block but also reestablishes neuromuscular reserve.