Safety and efficacy of sugammadex in management of patients with myasthenia gravis undergoing general anesthesia: A systematic review

Objective: The objective of this study was to analyze available evidence on efficacy and safety of sugammadex in reversing neuromuscular blockades in patients with Myasthenia Gravis (MG), thereby providing a comprehensive understanding of its potential benefits and risks in this specific patient pop...

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Main Authors: Alan D. Kaye, Emily A. Villafarra, Erin S. Everett, Erin E. Ware, Sydney A. Mashaw, William D. Brouillette, Camille G. Elder, Taylor Moss, Luke Muiznieks, Edwin Herron, Shahab Ahmadzadeh, Sahar Shekoohi
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:Heliyon
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Online Access:http://www.sciencedirect.com/science/article/pii/S2405844025001379
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author Alan D. Kaye
Emily A. Villafarra
Erin S. Everett
Erin E. Ware
Sydney A. Mashaw
William D. Brouillette
Camille G. Elder
Taylor Moss
Luke Muiznieks
Edwin Herron
Shahab Ahmadzadeh
Sahar Shekoohi
author_facet Alan D. Kaye
Emily A. Villafarra
Erin S. Everett
Erin E. Ware
Sydney A. Mashaw
William D. Brouillette
Camille G. Elder
Taylor Moss
Luke Muiznieks
Edwin Herron
Shahab Ahmadzadeh
Sahar Shekoohi
author_sort Alan D. Kaye
collection DOAJ
description Objective: The objective of this study was to analyze available evidence on efficacy and safety of sugammadex in reversing neuromuscular blockades in patients with Myasthenia Gravis (MG), thereby providing a comprehensive understanding of its potential benefits and risks in this specific patient population. Methods: We performed a systematic search for studies from PubMed, Embase, Web of Science, and Google Scholar. Sources were screened using Rayyan, following predefined inclusion and exclusion criteria focusing on English articles published from 2010 to 2024 on MG patients under general anesthesia. Data on patient characteristics and outcomes were extracted, and quality was appraised using the JBI Critical Appraisal Checklist. Results: Out of 361 initial citations, 24 studies met inclusion criteria. Sugammadex demonstrated rapid and effective reversal of neuromuscular blockades, with ToF recovery times ranging from 79.7 s to 10 min, and short extubation times. The incidence of postoperative myasthenic crisis was low, and no mortalities were reported. Conclusion: Sugammadex may serve as a reasonable option for the reversal of neuromuscular blockades in MG patients, indicating potential for rapid recovery and a relatively low incidence of serious complications. However, due to the limited number of studies and the nature of the evidence available, further large-scale and rigorous investigations are warranted to better establish its superiority over traditional reversal agents.
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spelling doaj-art-68d6646ef72e4bd4adfad7c454e6bb192025-02-02T05:28:06ZengElsevierHeliyon2405-84402025-01-01112e41757Safety and efficacy of sugammadex in management of patients with myasthenia gravis undergoing general anesthesia: A systematic reviewAlan D. Kaye0Emily A. Villafarra1Erin S. Everett2Erin E. Ware3Sydney A. Mashaw4William D. Brouillette5Camille G. Elder6Taylor Moss7Luke Muiznieks8Edwin Herron9Shahab Ahmadzadeh10Sahar Shekoohi11Departments of Anesthesiology and Pharmacology, Toxicology, and Neurosciences, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, 71103, USASchool of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, 71103, USASchool of Medicine, Tulane University School of Medicine, 1430 Tulane Ave, New Orleans, LA, 70112, USASchool of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, 71103, USASchool of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, 71103, USASchool of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, 71103, USASchool of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, 71103, USADepartment of Anesthesiology, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, 71103, USADepartment of Anesthesiology, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, 71103, USADepartment of Anesthesiology, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, 71103, USADepartment of Anesthesiology, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, 71103, USADepartment of Anesthesiology, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, 71103, USA; Corresponding author. Department of Anesthesiology, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, 71103, USA.Objective: The objective of this study was to analyze available evidence on efficacy and safety of sugammadex in reversing neuromuscular blockades in patients with Myasthenia Gravis (MG), thereby providing a comprehensive understanding of its potential benefits and risks in this specific patient population. Methods: We performed a systematic search for studies from PubMed, Embase, Web of Science, and Google Scholar. Sources were screened using Rayyan, following predefined inclusion and exclusion criteria focusing on English articles published from 2010 to 2024 on MG patients under general anesthesia. Data on patient characteristics and outcomes were extracted, and quality was appraised using the JBI Critical Appraisal Checklist. Results: Out of 361 initial citations, 24 studies met inclusion criteria. Sugammadex demonstrated rapid and effective reversal of neuromuscular blockades, with ToF recovery times ranging from 79.7 s to 10 min, and short extubation times. The incidence of postoperative myasthenic crisis was low, and no mortalities were reported. Conclusion: Sugammadex may serve as a reasonable option for the reversal of neuromuscular blockades in MG patients, indicating potential for rapid recovery and a relatively low incidence of serious complications. However, due to the limited number of studies and the nature of the evidence available, further large-scale and rigorous investigations are warranted to better establish its superiority over traditional reversal agents.http://www.sciencedirect.com/science/article/pii/S2405844025001379Myasthenia gravisNeuromuscular diseaseNeuromuscular blockadeReversalSugammadexNeostigmine
spellingShingle Alan D. Kaye
Emily A. Villafarra
Erin S. Everett
Erin E. Ware
Sydney A. Mashaw
William D. Brouillette
Camille G. Elder
Taylor Moss
Luke Muiznieks
Edwin Herron
Shahab Ahmadzadeh
Sahar Shekoohi
Safety and efficacy of sugammadex in management of patients with myasthenia gravis undergoing general anesthesia: A systematic review
Heliyon
Myasthenia gravis
Neuromuscular disease
Neuromuscular blockade
Reversal
Sugammadex
Neostigmine
title Safety and efficacy of sugammadex in management of patients with myasthenia gravis undergoing general anesthesia: A systematic review
title_full Safety and efficacy of sugammadex in management of patients with myasthenia gravis undergoing general anesthesia: A systematic review
title_fullStr Safety and efficacy of sugammadex in management of patients with myasthenia gravis undergoing general anesthesia: A systematic review
title_full_unstemmed Safety and efficacy of sugammadex in management of patients with myasthenia gravis undergoing general anesthesia: A systematic review
title_short Safety and efficacy of sugammadex in management of patients with myasthenia gravis undergoing general anesthesia: A systematic review
title_sort safety and efficacy of sugammadex in management of patients with myasthenia gravis undergoing general anesthesia a systematic review
topic Myasthenia gravis
Neuromuscular disease
Neuromuscular blockade
Reversal
Sugammadex
Neostigmine
url http://www.sciencedirect.com/science/article/pii/S2405844025001379
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