Τίτλος:
Sugammadex, a promising reversal drug. a review of clinical trials
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
According to published data, sugammadex, rapidly reverses (2-5 min) shallow and profound NM block induced by rocuronium and vecuronium, without being connected with serious adverse events. It is accepted that in order to reverse shallow block, the suggested dose of sugammadex comes up to 2 mg/kg. Profound level of NM block demands 4 mg/kg in order to defy few responses at the post titanic count. Doses of sugammadex lower than 1 mg/kg may lead to rebound of rocuronium's effect. Higher doses of sugammadex (12 - 16 mg/g) are used in rescue reversal. In children and adolescents the 2 mg/kg dose is both effective and well tolerated, while, to date, data regarding infants are scarce. In patients with renal failure, 2 mg/kg of sugammadex resulted in a mean time to recovery of TOF ratio to 0.9 in 2 min, which was quicker than the time of reversal by acetylcholinesterase inhibitors. Investigations in cardiac patients undergoing noncardiac surgery suggest that 2 and 4 mg/kg of sugammadex are both safe and effective. Compared with neostigmine, sugammadex has no need to use muscarinic antagonists and therefore is not associated with variations in heart rate. Trials indicate that sugammadex acts faster than edrophonium and neostigmine. Sugammadex is a promising, well tolerated agent that enables fast reversal in different depths of NM block -shallow and profound- and in different patients' populations. After completion of trial probation and settlement of issues concerning estimated cost and cost impact, it is believed to play a leading part in future anesthesiology. © 2011 Bentham Science Publishers Ltd.
Συγγραφείς:
Makri, I.
Papadima, A.
Lafioniati, A.
Pappas, A.B.
George, K.
Nikolaos, K.E.
Ioannis, C.D.
Charalambos, S.
Emmanuel, L.E.
Xanthos, T.
Papadimitriou, L.
Περιοδικό:
Reviews on Recent Clinical Trials
Λέξεις-κλειδιά:
cholinesterase inhibitor; edrophonium; inhalation anesthetic agent; intravenous anesthetic agent; muscarinic receptor blocking agent; neostigmine; propofol; rocuronium; sevoflurane; sugammadex; suxamethonium; vecuronium, abdominal discomfort; allergy; anaphylaxis; anesthesia (sensory dysfunction); anesthetic recovery; article; bispectral index; bradycardia; bronchospasm; clinical trial (topic); coughing; diarrhea; dizziness; drug antagonism; drug dose comparison; drug efficacy; drug tolerability; erythema; fever; headache; heart arrest; human; hypotension; kidney failure; malignant hyperthermia; myalgia; nausea; neuromuscular blocking; oliguria; phase 1 clinical trial (topic); phase 2 clinical trial (topic); phase 3 clinical trial (topic); priority journal; QT prolongation; side effect; tachycardia; vomiting; xerostomia, Clinical Trials as Topic; Dose-Response Relationship, Drug; gamma-Cyclodextrins; Humans; Neuromuscular Blockade; Neuromuscular Nondepolarizing Agents
DOI:
10.2174/157488711796575559
