7ème Journée de la Recherche Clinique : Efficacy of Sugammadex...

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Efficacy of Sugammadex for the Reversal of Moderate and Deep Rocuronium-induced Neuromuscular Block in Patients pretreated with Intravenous Magnesium de C. Czarnetzki lors de la 7ème Journée de la …

Efficacy of Sugammadex for the Reversal of Moderate and Deep Rocuronium-induced Neuromuscular Block in Patients pretreated with Intravenous Magnesium de C. Czarnetzki lors de la 7ème Journée de la Recherche Clinique aux HUG

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  • 1. Division of Anesthesiology, Geneva University Hospitals, Geneva, Switzerland (CC, CL, NE, MRT) Faculty of Medicine, University of Geneva, Geneva, Switzerland (MRT) Department of Anesthesiology and Intensive Care, University of Debrecen, Debrecen, Hungary (ET) Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland (NE.
  • 2. Neuromuscular endplate Neuromuscular monitoring: TOF Watch Neuromuscular monitoring: Single twitch and Train-of-Four stimulation Neuromuscular transmission
  • 3. Sugammadex antagonises Rocuronium through encapsulation Rocuronium Sugammadex Encapsulation
  • 4. Magnesium is frequently used in daily clinical practice: obstetrics, cardiology, intensive care, anaesthesiology Magnesium interacts with neuromuscular transmission Magnesium and neuromuscular transmission
  • 5. Czarnetzki et al. Acta Anaesthesiol Scand 2010:54:299-306
  • 6. To investigate whether magnesium decreases the efficacy of sugammadex for the reversal of rocuronium-induced neuromuscular block Aim of the study Hans et al. Eur J Anaesthesiol 2010; X: YYY-YYY Vulnerability of the neuromuscular transmission after normalisation to TOF 0.9
  • 7. Study design Moderate block = 2 twitches Deep block = Post-tetanic count 2
  • 8. Results (I): Reversal of moderate block
  • 9. Results (I): Reversal of deep block
  • 10. The efficacy of recommended doses of sugammadex for the reversal of moderate and deep rocuronium-induced block is preserved despite the administration of a single IV infusion of magnesium. Conclusions Recommended doses of sugammadex allow for encapsulating the majority of rocuronium molecules that are present at the neuromuscular junction. Sugammadex, within the recommended dose regimens, not only antagonizes the neuromuscular block but also reestablishes neuromuscular reserve.