Sugammadex Reversal of Profound Vecuronium Block
Sugammadex Reversal of Profound Vecuronium Block
A Critical Appraisal of Quantitative Research
The purpose of this specific study is to compare the neuromuscular block reversal rates and effects for sugammadex, a selective relaxant binding agent, with neostigmine. In many types of surgery, there appears to be a benefit for the patient to be kept in a state of profound relaxation throughout the entire procedure. Anesthesiologists are usually hindered in this goal through the surgery in its entirety because of the inability of standard agents to rapidly reverse such profound neuromuscular block. This forces anesthesiologists to restrict the level of neuromuscular block near the end of surgery (Lemmens, El-Orbany, Berry & Martin, 2010). Since sugammadex has the potential to decrease the time necessary to reduce neuromuscular block, there is an opportunity for it to aid anesthesiologists by allowing them to extend the duration of the profound relaxation later into a procedure. This study was built around the framework that sugammadex has been shown to successfully reverse rocuronium induced profound blocks to a train of four ration of .9 relatively quickly. The concept of interest here, then, is whether or not these properties of sugammadex can translate into faster block reversals when using vecuronium, which is more potent than rocuronium (Lemmens, El-Orbany, Berry & Martin, 2010). Furthermore, the conceptual interest includes the existence of any serious adverse effects in doing so.
The sample size was ninety-four patients spread randomly across eight centers in the United States. Originally it was planned that fifty-two patients receive sugammadex and the rest receive neostigmine. The population consisted of adults with American Society of Anesthesiologist (ASA) class I-IV receiving general endotracheal anesthesia for elective surgery requiring neuromuscular blockade both for induction and maintenance. They were further limited to
A Critical Appraisal of Quantitative Research
The purpose of this specific study is to compare the neuromuscular block reversal rates and effects for sugammadex, a selective relaxant binding agent, with neostigmine. In many types of surgery, there appears to be a benefit for the patient to be kept in a state of profound relaxation throughout the entire procedure. Anesthesiologists are usually hindered in this goal through the surgery in its entirety because of the inability of standard agents to rapidly reverse such profound neuromuscular block. This forces anesthesiologists to restrict the level of neuromuscular block near the end of surgery (Lemmens, El-Orbany, Berry & Martin, 2010). Since sugammadex has the potential to decrease the time necessary to reduce neuromuscular block, there is an opportunity for it to aid anesthesiologists by allowing them to extend the duration of the profound relaxation later into a procedure. This study was built around the framework that sugammadex has been shown to successfully reverse rocuronium induced profound blocks to a train of four ration of .9 relatively quickly. The concept of interest here, then, is whether or not these properties of sugammadex can translate into faster block reversals when using vecuronium, which is more potent than rocuronium (Lemmens, El-Orbany, Berry & Martin, 2010). Furthermore, the conceptual interest includes the existence of any serious adverse effects in doing so.
The sample size was ninety-four patients spread randomly across eight centers in the United States. Originally it was planned that fifty-two patients receive sugammadex and the rest receive neostigmine. The population consisted of adults with American Society of Anesthesiologist (ASA) class I-IV receiving general endotracheal anesthesia for elective surgery requiring neuromuscular blockade both for induction and maintenance. They were further limited to
References: Lemmens, H. J., El-Orbany, M. I., Berry, J., & Martin, G. (2010). Reversal of profound vecuronium-induced neuromuscular block under sevoflurane anesthesia: sugammadex versus neostigmine. . BMC Anesthesiology, 10(15), doi: 10.1186/1471-2253-10-15 Morgan, G.E., Mikhail, M.S., & Murray, M.J. (2006). Clinical anesthesiology (4thed.). New York: McGraw-Hill. Nagelhout, J.J., & Plaus, K.L. (2010). Nurse anesthesia (4th ed.). St. Louis,MO: ElsevierSaunders.