Sugammadex: su eficacia y seguridad en la reversión selectiva del vecuronio

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.