Anesth Analg 2007;105:883-884
© 2007 International Anesthesia Research Society
doi: 10.1213/01.ane.0000269685.86443.a8
LETTER TO THE EDITOR
Section Editor: Lawrence Saidman
Sugammadex–Rocuronium Dosing
Aaron F. Kopman, MD
Department of Anesthesiology (N.R. 408); Saint Vincent's Hospital Manhattan; New York, NY; akopman{at}nyc.rr.com or akopman{at}gmail.com
To the Editor:
In their recent dose-finding study, Groudine et al. (1) note that the molecular weight of sugammadex is 3.6 times that of rocuronium. They postulate that these drugs bind in a 1:1 ratio, and that as a result 1.8 mg/kg sugammadex should encapsulate all the rocuronium administered in a 0.50 mg/kg dose.
This hypothesis is perhaps overly simplistic as it does not explain all available clinical data. Following rocuronium 1.2 mg/kg, sugammadex 4.0 mg/kg does not produce prompt and complete neuromuscular block if administered 3 min (2) or 5 min later (3). Until all the data are in, I would suggest that it is premature to suggest that when sugammadex and rocuronium are administered in equimolar amounts that complete reversal of neuromuscular block will necessarily ensue.
REFERENCES
- Groudine SB, Soto R, Lien C, Drover D, Roberts K. A randomized, dose-finding, phase II study of the selective relaxant binding drug, sugammadex, capable of safely reversing profound rocuronium-induced neuromuscular block. Anesth Analg 2007;104:555–62[Abstract/Free Full Text]
- Rex C, Khuenl-Brady K, Sielenkaemper A, Kjaer CC, Puehringer FK. Reversal of high-dose rocuronium (1.2 mg/kg) with org 25969. Anesthesiology 2005;103:A1129
- de Boer H, Marcus M, Schouten P, Heeringa M, Driessen J. Reversal of rocuronium-induced (1.2 mg · kg–1) neuromuscular block by org 25969: a multi center dose finding and safety study. Anesthesiology 2005;103:A1117
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