bachelorThesis
Sugammadex: su eficacia y seguridad en la reversión selectiva del vecuronio
Author
Morales Escobar, Viviana
Institutions
Abstract
Introduction: With the regular use of muscle relaxants (neuromuscular blockade) agents
since 1942 and later examination in 1979, a high incidence of residual neuromuscular
blockade was established up to 45% with 0.9 of TOF. Moreover this is also related with
multiple breathing complications increasing hospital stay in immediately postoperative
patients.
Methods: Systematic review of scientific literature providing information about response
to sugammadex when used to reverse vecuronium's effects, due to being the first drug that
has demonstrated efficiency and safety in reversion of non-depolarizing steroid relaxants,
helping to prevent postoperative residual blockade.
Results: A research was carried out by using EMBASE, EBSCO and MEDLINE
databases, with time scope from January 2000 to December 2012, using "MeSH",
"sugammadex" and "vecuronium" as keywords. A set of clinical controlled trials papers
concerning sugammadex comparisons versus placebo or other drugs were established, for
human adults over 18 years old. As a result there is a significant time reduction in moderate
neuromuscular blockade recovery ranging from 1.5 to 2.3 minutes with sugammadex in
contrast with neostigmine with a 18.9 to 66.2 minutes average. For deep blockade
sugammadex recovery results were found ranging from 35.5-68.4 minutes with 0.5
milligrams per Kg doses up to 1.4-1.7 with 8 milligrams per Kg.
Discussion: Favorable results were achieved when using higher doses to 2 milligrams per
Kg. in moderate neuromuscular blockade patients, and higher doses to 4 milligrams per Kg.
for deep blockade.
Conclusions: Evidence suggests that there is in fact an adequate reversion of vecuronium
neuromuscular blockade effects when using sugammadex, with significant time decrease
and higher patient recovery rate without residual blockade or recurarization.