Sugammadex

Excerpt

Sugammadex is a modified gamma-cyclodextrin that is used to reverse steroidal non-depolarizing neuromuscular blocking drugs rocuronium and vecuronium. Residual neuromuscular blockade is common after surgery, with an estimated 30 to 60% incidence in the recovery room. The low-level neuromuscular blockade, lower than what can be observed with the naked eye, has been linked to hypoxia, supralaryngeal muscle weakness that predisposes to upper airway obstruction, impaired swallowing, and an increased risk for aspiration. Sugammadex increases the speed of neuromuscular blockade reversal and greatly reduces the risk for residual neuromuscular paralysis. It does not inhibit acetylcholinesterase-like traditional reversal agents, such as neostigmine; therefore, using an antimuscarinic agent such as glycopyrrolate is unnecessary. This activity outlines the indications, mechanisms of action, methods of administration, important adverse effects, contraindications, and monitoring, of sugammadex, so providers can direct patient therapy in treating indicated disorders as part of the interprofessional team with a basis on the current knowledge for optimal utilization.