The concept behind sugammadex

Rev Esp Anestesiol Reanim. 2014 May;61(5):272-6. doi: 10.1016/j.redar.2014.02.001. Epub 2014 Mar 15.

Abstract

Sugammadex is the first selective relaxant binding agent. It allows rapid reversal of any degree of neuromuscular blockade induced by steroidal neuromuscular blocking agents. Sugammadex acts by encapsulation of the neuromuscular blocking agent. This prevents the drug from acting on prejunctional and postjunctional nicotinic receptors, allowing acetylcholine to activate these receptors, and resulting in reversal of the neuromuscular blockade. Objective monitoring of the degree of neuromuscular blockade is strongly recommended to determine the optimal dose of sugammadex. A good understanding of the concept behind sugammadex is essential in order to use this reversal agent in clinical practice.

Keywords: Farmacología; Fármacos bloqueantes neuromusculares; Neuromuscular blocking agents; Pharmacology; Reversal; Reversión; Rocuronio; Rocuronium; Sugammadex; Vecuronio; Vecuronium.

Publication types

  • Review

MeSH terms

  • Acetylcholine / metabolism
  • Acetylcholine / physiology
  • Androstanols / administration & dosage
  • Androstanols / antagonists & inhibitors*
  • Androstanols / blood
  • Binding, Competitive
  • Delayed Emergence from Anesthesia / drug therapy*
  • Dose-Response Relationship, Drug
  • Humans
  • Neuromuscular Nondepolarizing Agents / administration & dosage
  • Neuromuscular Nondepolarizing Agents / antagonists & inhibitors*
  • Neuromuscular Nondepolarizing Agents / blood
  • Osmolar Concentration
  • Receptors, Nicotinic / drug effects
  • Receptors, Nicotinic / physiology
  • Rocuronium
  • Sugammadex
  • Vecuronium Bromide / administration & dosage
  • Vecuronium Bromide / antagonists & inhibitors*
  • Vecuronium Bromide / blood
  • gamma-Cyclodextrins / administration & dosage
  • gamma-Cyclodextrins / pharmacology*
  • gamma-Cyclodextrins / therapeutic use

Substances

  • Androstanols
  • Neuromuscular Nondepolarizing Agents
  • Receptors, Nicotinic
  • gamma-Cyclodextrins
  • Sugammadex
  • Vecuronium Bromide
  • Acetylcholine
  • Rocuronium