Management of Residual Neuromuscular Blockade Recovery: Age-Old Problem with a New Solution
Neostigmine has been traditionally used as the agent of choice to reverse Neuromuscular Blockade (NMB) after muscle paralysis during general anesthesia. However, the use of neostigmine has not been without untoward events. Sugammadex is a novel drug that selectively binds to aminosteroid nondepolari...
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| Format: | Article |
| Language: | English |
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Wiley
2017-01-01
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| Series: | Case Reports in Anesthesiology |
| Online Access: | http://dx.doi.org/10.1155/2017/8197035 |
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| author | Michael S. Green Archana Gundigi Venkatesh Ranjani Venkataramani |
| author_facet | Michael S. Green Archana Gundigi Venkatesh Ranjani Venkataramani |
| author_sort | Michael S. Green |
| collection | DOAJ |
| description | Neostigmine has been traditionally used as the agent of choice to reverse Neuromuscular Blockade (NMB) after muscle paralysis during general anesthesia. However, the use of neostigmine has not been without untoward events. Sugammadex is a novel drug that selectively binds to aminosteroid nondepolarizing muscle relaxants and reverses even a deep level of NMB. Controversy exists regarding the optimal dose of sugammadex that is effective in reversing the NMB after the incomplete reversal with neostigmine and glycopyrrolate. We discuss a case where sugammadex reduced the time of the recovery from NMB in a patient who had incomplete antagonisms following adequate treatment with neostigmine, aiding timely extubation without persistent residual NMB, and hence prevented the requirement of postoperative ventilation and the improvement in patient care. More randomized control studies are needed in order to conclude the appropriate dose of sugammadex in cases of incomplete reversal. |
| format | Article |
| id | doaj-art-a19d28b31bad4331a49e2481f9f5df23 |
| institution | Kabale University |
| issn | 2090-6382 2090-6390 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Anesthesiology |
| spelling | doaj-art-a19d28b31bad4331a49e2481f9f5df232025-02-03T01:11:12ZengWileyCase Reports in Anesthesiology2090-63822090-63902017-01-01201710.1155/2017/81970358197035Management of Residual Neuromuscular Blockade Recovery: Age-Old Problem with a New SolutionMichael S. Green0Archana Gundigi Venkatesh1Ranjani Venkataramani2Department of Anesthesiology and Perioperative Medicine, Drexel University College of Medicine, 245 N. 15th Street, Suite 7502, MS 310, Philadelphia, PA 19102, USADepartment of Anesthesiology and Perioperative Medicine, Drexel University College of Medicine, 245 N. 15th Street, Suite 7502, MS 310, Philadelphia, PA 19102, USADepartment of Anesthesiology and Perioperative Medicine, Drexel University College of Medicine, 245 N. 15th Street, Suite 7502, MS 310, Philadelphia, PA 19102, USANeostigmine has been traditionally used as the agent of choice to reverse Neuromuscular Blockade (NMB) after muscle paralysis during general anesthesia. However, the use of neostigmine has not been without untoward events. Sugammadex is a novel drug that selectively binds to aminosteroid nondepolarizing muscle relaxants and reverses even a deep level of NMB. Controversy exists regarding the optimal dose of sugammadex that is effective in reversing the NMB after the incomplete reversal with neostigmine and glycopyrrolate. We discuss a case where sugammadex reduced the time of the recovery from NMB in a patient who had incomplete antagonisms following adequate treatment with neostigmine, aiding timely extubation without persistent residual NMB, and hence prevented the requirement of postoperative ventilation and the improvement in patient care. More randomized control studies are needed in order to conclude the appropriate dose of sugammadex in cases of incomplete reversal.http://dx.doi.org/10.1155/2017/8197035 |
| spellingShingle | Michael S. Green Archana Gundigi Venkatesh Ranjani Venkataramani Management of Residual Neuromuscular Blockade Recovery: Age-Old Problem with a New Solution Case Reports in Anesthesiology |
| title | Management of Residual Neuromuscular Blockade Recovery: Age-Old Problem with a New Solution |
| title_full | Management of Residual Neuromuscular Blockade Recovery: Age-Old Problem with a New Solution |
| title_fullStr | Management of Residual Neuromuscular Blockade Recovery: Age-Old Problem with a New Solution |
| title_full_unstemmed | Management of Residual Neuromuscular Blockade Recovery: Age-Old Problem with a New Solution |
| title_short | Management of Residual Neuromuscular Blockade Recovery: Age-Old Problem with a New Solution |
| title_sort | management of residual neuromuscular blockade recovery age old problem with a new solution |
| url | http://dx.doi.org/10.1155/2017/8197035 |
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