Comparison of the Effects of Sugammadex Recommended Dose (2 mg/kg) and Fixed Dose of 200 mg on the Reversal of Moderate Neuromuscular Block and Recovery Profile in Adult Patients
<i>Background and Objectives</i>: Neuromuscular blocking agents are essential to ensure optimal surgical conditions during general anesthesia. Sugammadex, a selective binding agent, is widely used to reverse neuromuscular blockade. While weight-based dosing (2 mg/kg for moderate blockade...
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2025-01-01
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| author | Ji-Yoon Jung Sung-Ae Cho Woojin Kwon Hongwook Kim Tae-Yun Sung |
| author_facet | Ji-Yoon Jung Sung-Ae Cho Woojin Kwon Hongwook Kim Tae-Yun Sung |
| author_sort | Ji-Yoon Jung |
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| description | <i>Background and Objectives</i>: Neuromuscular blocking agents are essential to ensure optimal surgical conditions during general anesthesia. Sugammadex, a selective binding agent, is widely used to reverse neuromuscular blockade. While weight-based dosing (2 mg/kg for moderate blockade) is recommended, many clinicians administer a fixed dose of 200 mg in clinical practice, potentially leading to overdosing. This study aimed to compare the efficacy and recovery profiles of weight-based and fixed-dose sugammadex in patients undergoing general anesthesia. <i>Materials and Methods</i>: In this randomized controlled trial, 20 patients were divided into two groups: the recommended dose group (R group, 2 mg/kg) and the fixed dose group (F group, 200 mg). Primary outcomes included time to achieve a normalized train-of-four (TOF) ratio of 0.9. Secondary outcomes included recovery time, time to spontaneous respiration, response to verbal commands and extubation, and adverse events. <i>Results</i>: The median time to achieve a normalized TOF ratio of 0.9 was 2.3 min in the R group and 2.0 min in the F group (<i>p</i> = 0.529). Secondary outcomes, including recovery time and time to extubation showed no significant differences. Adverse events were minimal and comparable between groups. <i>Conclusions</i>: The fixed-dose sugammadex (200 mg) demonstrated similar efficacy and safety to weight-based dosing (2 mg/kg) in reversing moderate neuromuscular blockade. These findings do not allow abandoning the recommendation of adjustment for body weight, particularly in patients with low body weight or comorbidities. |
| format | Article |
| id | doaj-art-70fc8441a572464a8804c554f1198ed3 |
| institution | Kabale University |
| issn | 1010-660X 1648-9144 |
| language | English |
| publishDate | 2025-01-01 |
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| series | Medicina |
| spelling | doaj-art-70fc8441a572464a8804c554f1198ed32025-01-24T13:40:53ZengMDPI AGMedicina1010-660X1648-91442025-01-0161115110.3390/medicina61010151Comparison of the Effects of Sugammadex Recommended Dose (2 mg/kg) and Fixed Dose of 200 mg on the Reversal of Moderate Neuromuscular Block and Recovery Profile in Adult PatientsJi-Yoon Jung0Sung-Ae Cho1Woojin Kwon2Hongwook Kim3Tae-Yun Sung4Department of Anaesthesiology and Pain Medicine, Konyang University Hospital, Konyang University Myunggok Medical Research Institute, Konyang University College of Medicine, Daejeon 35365, Republic of KoreaDepartment of Anaesthesiology and Pain Medicine, Konyang University Hospital, Konyang University Myunggok Medical Research Institute, Konyang University College of Medicine, Daejeon 35365, Republic of KoreaDepartment of Anaesthesiology and Pain Medicine, Konyang University Hospital, Konyang University Myunggok Medical Research Institute, Konyang University College of Medicine, Daejeon 35365, Republic of KoreaDepartment of Urology, Konyang University Hospital, Konyang University College of Medicine, Daejeon 35365, Republic of KoreaDepartment of Anaesthesiology and Pain Medicine, Konyang University Hospital, Konyang University Myunggok Medical Research Institute, Konyang University College of Medicine, Daejeon 35365, Republic of Korea<i>Background and Objectives</i>: Neuromuscular blocking agents are essential to ensure optimal surgical conditions during general anesthesia. Sugammadex, a selective binding agent, is widely used to reverse neuromuscular blockade. While weight-based dosing (2 mg/kg for moderate blockade) is recommended, many clinicians administer a fixed dose of 200 mg in clinical practice, potentially leading to overdosing. This study aimed to compare the efficacy and recovery profiles of weight-based and fixed-dose sugammadex in patients undergoing general anesthesia. <i>Materials and Methods</i>: In this randomized controlled trial, 20 patients were divided into two groups: the recommended dose group (R group, 2 mg/kg) and the fixed dose group (F group, 200 mg). Primary outcomes included time to achieve a normalized train-of-four (TOF) ratio of 0.9. Secondary outcomes included recovery time, time to spontaneous respiration, response to verbal commands and extubation, and adverse events. <i>Results</i>: The median time to achieve a normalized TOF ratio of 0.9 was 2.3 min in the R group and 2.0 min in the F group (<i>p</i> = 0.529). Secondary outcomes, including recovery time and time to extubation showed no significant differences. Adverse events were minimal and comparable between groups. <i>Conclusions</i>: The fixed-dose sugammadex (200 mg) demonstrated similar efficacy and safety to weight-based dosing (2 mg/kg) in reversing moderate neuromuscular blockade. These findings do not allow abandoning the recommendation of adjustment for body weight, particularly in patients with low body weight or comorbidities.https://www.mdpi.com/1648-9144/61/1/151neuromuscular blocking agentssugammadexneuromuscular monitoring |
| spellingShingle | Ji-Yoon Jung Sung-Ae Cho Woojin Kwon Hongwook Kim Tae-Yun Sung Comparison of the Effects of Sugammadex Recommended Dose (2 mg/kg) and Fixed Dose of 200 mg on the Reversal of Moderate Neuromuscular Block and Recovery Profile in Adult Patients Medicina neuromuscular blocking agents sugammadex neuromuscular monitoring |
| title | Comparison of the Effects of Sugammadex Recommended Dose (2 mg/kg) and Fixed Dose of 200 mg on the Reversal of Moderate Neuromuscular Block and Recovery Profile in Adult Patients |
| title_full | Comparison of the Effects of Sugammadex Recommended Dose (2 mg/kg) and Fixed Dose of 200 mg on the Reversal of Moderate Neuromuscular Block and Recovery Profile in Adult Patients |
| title_fullStr | Comparison of the Effects of Sugammadex Recommended Dose (2 mg/kg) and Fixed Dose of 200 mg on the Reversal of Moderate Neuromuscular Block and Recovery Profile in Adult Patients |
| title_full_unstemmed | Comparison of the Effects of Sugammadex Recommended Dose (2 mg/kg) and Fixed Dose of 200 mg on the Reversal of Moderate Neuromuscular Block and Recovery Profile in Adult Patients |
| title_short | Comparison of the Effects of Sugammadex Recommended Dose (2 mg/kg) and Fixed Dose of 200 mg on the Reversal of Moderate Neuromuscular Block and Recovery Profile in Adult Patients |
| title_sort | comparison of the effects of sugammadex recommended dose 2 mg kg and fixed dose of 200 mg on the reversal of moderate neuromuscular block and recovery profile in adult patients |
| topic | neuromuscular blocking agents sugammadex neuromuscular monitoring |
| url | https://www.mdpi.com/1648-9144/61/1/151 |
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