• Expert Rev Neurother · May 2009

    Review

    Sugammadex: a selective relaxant binding agent for reversal of neuromuscular block.

    • Rosemary M G Hogg and Rajinder K Mirakhur.
    • Department of Anaesthetics and ICM, Queen's University, Belfast, UK.
    • Expert Rev Neurother. 2009 May 1;9(5):599-608.

    AbstractNeostigmine, the currently used agent for reversal of neuromuscular block, has several drawbacks, such as a slow onset of peak effect, inability to reverse deep block and the occurrence of widespread muscarinic effects. Sugammadex is a new class of reversal agent that acts by encapsulating the molecules of the relaxants rocuronium and vecuronium, for which it is a specific antagonist. Clinical trials in over 2000 subjects have shown it to be effective for reversal of block by these two relaxants even from deep levels, in doses of 2.0-4.0 mg/kg. Sugammadex can also reverse an intense (profound) high-dose rocuronium block, but the dose required in this situation is 16.0 mg/kg. The agent has been found to be safe so far, with few side effects.

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