BACKGROUND Postoperative residual neuromuscular blockade (NMB), defined as a train-of-four (TOF) ratio of <0.9, is an established risk factor for critical postoperative respiratory events and increased morbidity. At present, little is known about the occurrence of residual NMB in Canada. The RECITE (Residual Curarization and its Incidence at Tracheal Extubation) study was a prospective observat...

Sugammadex was introduced to Royal Perth Hospital in early 2011 without access restriction. Two departmental audits (26-page online survey and 1-week in-theatre snapshot audit) were undertaken to investigate the change of beliefs and clinical practice related to the use of neuromuscular blocking agents at the Royal Perth Hospital since this introduction. Results were compared with data from 201...

AANA Journal June 2009 Vol. 77, No. 3 219 Sugammadex sodium is the generic drug name for the novel modified gamma cyclodextrin that terminates neuromuscular blockade induced by aminosteroidal neuromuscular blocking agents. Published phase II and phase III clinical data support preclinical and clinical phase I study findings of fast, safe, and efficacious reversal of all levels of neuromuscular ...

Neuromuscular blocking drugs are not as notorious for producing adverse reactions as the i.v. induction agents; nevertheless, to a varying degree they all produce unfavourable or harmful effects. The newer non-depolarizing neuromuscular blockers, atracurium and vecuronium, have been developed in an attempt to overcome the disadvantages of the earlier drugs, but although much more specific agent...

neostigmine), reverses neuromuscular blockade rapidly and effectively by encapsulating free circulating steroidal neuromuscular blocking agents (e.g., rocuronium) directly [1]. Moreover, sugammadex does not have muscarinic properties, whereas neostigmine has significant adverse muscarinic effects. Therefore, sugammadex is used in many countries as a new neuromuscular reversal agent to antagoniz...

One of the challenges during the perioperative care of patients with myotonic dystrophy is the reversal of neuromuscular blocking agents. Agents that inhibit acetylcholinesterase, such as neostigmine, may precipitate myotonia, and are therefore relatively contraindicated. Sugammadex is a novel pharmacologic agent, which encapsulates rocuronium or vecuronium, thereby reversing their effect. We r...

Neuromuscular blocking agents are frequently used in the Intensive Care Unit to facilitate tracheal intubation and the application of continuous paralysis. This review will focus on various conditions of the critically ill patient such as multi-organ dysfunction, acid-base and electrolyte imbalance, prolonged immobility, multiple drug interactions and specific disease/injury processes that may ...