Neuromuscular Blockade Clinical Trial
Official title:
Dose Finding Study for Reversal of Vecuronium-induced Neuromuscular Blockade at Train-of-four Ratio 0.3 With Sugammadex and Neostigmine
The aim of this study is to estimate the optimal dose of sugammadex and neostigmine reversal of a vecuronium-induced residual neuromuscular block at train-of-four ratio 0.3.
Sugammadex is a modified γ-cyclodextrin compound that reverses the neuromuscular blockade
produced by steroidal nondepolarizing muscle relaxants such as rocuronium,vecuronium and
pipecuronium by encapsulating them, making them unavailable to interact with the nicotinic
acetylcholine receptors at the neuromuscular junction.However, residual neuromuscular blocks
between reappearance of T4 and train-of-four ratio (TOFR)=0.5 are more frequent in clinical
practice compared with profound or deep blocks and have not been investigated for sugammadex
previously.
Unlike neostigmine, sugammadex is efficacious in reversing profound (no responses to either
train-of-four (TOF) or posttetanic count stimulation) or deep (posttetanic count of 1 or 2)
neuromuscular block (NMB) in doses of 16 and 4 mg/kg, respectively. However, shallow
neuromuscular blocks are more frequent in clinical practice compared with profound or deep
blocks and have not been investigated for sugammadex previously.
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