Abstract | BACKGROUND: METHODS: Thirty adult patients were studied: 15 renally impaired [ creatinine clearance (CL(CR)) <30 ml min(-1)] and 15 controls (CL(CR)>80 ml min(-1)). Anaesthesia was induced and maintained using i.v. opiates and propofol. Neuromuscular monitoring was performed by acceleromyography and train-of-four (TOF) nerve stimulation. Rocuronium (0.6 mg kg(-1)) was given, followed by a single i.v. dose of sugammadex (2.0 mg kg(-1)) at reappearance of the second twitch of the TOF. The primary efficacy variable was time from administration of sugammadex to recovery of the TOF ratio to 0.9. Safety variables included clinical evidence of reoccurrence of NMB. RESULTS: After sugammadex administration, the mean (sd) time to recovery of the TOF ratio to 0.9 was 2.0 (0.72) min in renal patients and 1.65 (0.63) min in controls (NS). Recurrence of NMB was not observed in any patient. No sugammadex-related serious adverse events were reported. CONCLUSIONS:
Sugammadex administered at reappearance of T(2) rapidly and effectively reverses NMB induced by rocuronium in renal failure and healthy patients. Sugammadex was well tolerated by all patients. Further safety studies on sugammadex in patients with severe renal impairment are warranted.
|
Authors | L M Staals, M M J Snoeck, J J Driessen, E A Flockton, M Heeringa, J M Hunter |
Journal | British journal of anaesthesia
(Br J Anaesth)
Vol. 101
Issue 4
Pg. 492-7
(Oct 2008)
ISSN: 1471-6771 [Electronic] England |
PMID | 18653492
(Publication Type: Clinical Trial, Phase III, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
|
Chemical References |
- Androstanols
- Neuromuscular Nondepolarizing Agents
- gamma-Cyclodextrins
- Sugammadex
- Rocuronium
|
Topics |
- Adult
- Aged
- Aged, 80 and over
- Androstanols
(antagonists & inhibitors, pharmacology)
- Anesthesia Recovery Period
- Anesthesia, General
- Female
- Humans
- Kidney Failure, Chronic
(physiopathology)
- Male
- Middle Aged
- Neuromuscular Blockade
(methods)
- Neuromuscular Junction
(drug effects, physiology)
- Neuromuscular Nondepolarizing Agents
(antagonists & inhibitors, pharmacology)
- Rocuronium
- Sugammadex
- gamma-Cyclodextrins
(adverse effects, pharmacology)
|