Open AccessSugammadex: Applications in Pediatric Critical Care
Author(s) -
Joseph D. Tobias
Publication year - 2020
Publication title -
journal of pediatric intensive care
Language(s) - English
Resource type - Journals
eISSN - 2146-4618
pISSN - 2146-4626
DOI - 10.1055/s-0040-1705133
Subject(s) - sugammadex , neuromuscular blockade , medicine , neostigmine , rocuronium , neuromuscular transmission , dosing , anesthesia , population , acetylcholinesterase , adverse effect , neuromuscular blocking agents , clinical trial , intensive care medicine , blockade , pharmacology , intubation , biochemistry , chemistry , enzyme , receptor , environmental health
Sugammadex is a novel pharmacologic agent, which reverses neuromuscular blockade with a mechanism that differs from acetylcholinesterase inhibitors such as neostigmine. There is a growing body of literature demonstrating its efficacy in pediatric patients of all ages. Prospective trials have demonstrated a more rapid and more complete reversal of rocuronium-induced neuromuscular blockade than the acetylcholinesterase inhibitor, neostigmine. Unlike the acetylcholinesterase inhibitors, sugammadex effectively reverses intense or complete neuromuscular blockade. It may also be effective in situations where reversal of neuromuscular blockade is problematic including patients with neuromyopathic conditions or when acetylcholinesterase inhibitors are contraindicated. This article reviews the physiology of neuromuscular transmission as well as the published literature, regarding the use of sugammadex in pediatric population including the pediatric intensive care unit population. Clinical applications are reviewed, adverse effects are discussed, and dosing algorithms are presented.