Reversal of rocuronium‐induced intense neuromuscular blockade by sugammadex in Korean children: A pharmacokinetic and pharmacodynamic analysis
Abstract Sugammadex, a selective antagonist of steroidal non‐depolarizing neuromuscular blocking agents, has been used in children in limited circumstances. However, neither pharmacokinetics (PKs) nor recovery profile of sugammadex for intense neuromuscular blockade reversal in children have been re...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-01-01
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| Series: | Clinical and Translational Science |
| Online Access: | https://doi.org/10.1111/cts.13429 |
| _version_ | 1828063212078104576 |
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| author | Sang‐Hwan Ji Ki Young Huh Jaeseong Oh Hee‐Jeong Jeong Young‐Eun Jang Eun‐Hee Kim Ji‐Hyun Lee Jin‐Tae Kim Hee‐Soo Kim |
| author_facet | Sang‐Hwan Ji Ki Young Huh Jaeseong Oh Hee‐Jeong Jeong Young‐Eun Jang Eun‐Hee Kim Ji‐Hyun Lee Jin‐Tae Kim Hee‐Soo Kim |
| author_sort | Sang‐Hwan Ji |
| collection | DOAJ |
| description | Abstract Sugammadex, a selective antagonist of steroidal non‐depolarizing neuromuscular blocking agents, has been used in children in limited circumstances. However, neither pharmacokinetics (PKs) nor recovery profile of sugammadex for intense neuromuscular blockade reversal in children have been reported. This prospective study aimed to obtain a PK model of sugammadex and evaluate its efficacy and safety for intense neuromuscular blockade reversal in children. Forty children (age, 2–17 years) who underwent surgery that required early neuromuscular blockade reversal were enrolled. After neuromuscular blockade with 1 mg∙kg−1 of rocuronium, sugammadex (2, 4, and 8 mg∙kg−1) or a conventional dose of neostigmine (0.03 mg∙kg−1) was administered randomly after confirmation of zero post‐tetanic count. The plasma concentrations of rocuronium and sugammadex were measured 2 min after rocuronium injection; immediately before, 2, 5, 15, 60, 120, 240, and 480 min after the study drug injection. Response to train‐of‐four stimulation was continuously recorded. Noncompartmental analysis and population PK modeling were performed. For pharmacodynamics, the recovery profile was measured. Three‐compartment PK model was established for sugammadex. The median (interquartile range [IQR]) time from injection of 8 mg∙kg−1 of sugammadex to recovery of T4/T1greater than or equal to 0.9 at train‐of‐four stimulation was 1.1 (IQR: 0.88–1.8) min. No adverse events related to sugammadex were observed. We present a PK analysis of sugammadex for rocuronium‐induced intense neuromuscular blockade reversal in children with its recovery profile. The time to recover T4/T1 greater than or equal to 0.9 at train‐of‐four stimulation with 8 mg∙kg−1 of sugammadex was less than 3 min and comparable to that in adults. |
| first_indexed | 2024-04-10T22:39:38Z |
| format | Article |
| id | doaj.art-7a9ef6c79132484db1d2abf6f076c2ef |
| institution | Directory Open Access Journal |
| issn | 1752-8054 1752-8062 |
| language | English |
| last_indexed | 2024-04-10T22:39:38Z |
| publishDate | 2023-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Clinical and Translational Science |
| spelling | doaj.art-7a9ef6c79132484db1d2abf6f076c2ef2023-01-16T08:07:54ZengWileyClinical and Translational Science1752-80541752-80622023-01-011619210310.1111/cts.13429Reversal of rocuronium‐induced intense neuromuscular blockade by sugammadex in Korean children: A pharmacokinetic and pharmacodynamic analysisSang‐Hwan Ji0Ki Young Huh1Jaeseong Oh2Hee‐Jeong Jeong3Young‐Eun Jang4Eun‐Hee Kim5Ji‐Hyun Lee6Jin‐Tae Kim7Hee‐Soo Kim8Seoul National University College of Medicine Seoul KoreaSeoul National University College of Medicine Seoul KoreaSeoul National University College of Medicine Seoul KoreaSeoul National University College of Medicine Seoul KoreaSeoul National University College of Medicine Seoul KoreaSeoul National University College of Medicine Seoul KoreaSeoul National University College of Medicine Seoul KoreaSeoul National University College of Medicine Seoul KoreaSeoul National University College of Medicine Seoul KoreaAbstract Sugammadex, a selective antagonist of steroidal non‐depolarizing neuromuscular blocking agents, has been used in children in limited circumstances. However, neither pharmacokinetics (PKs) nor recovery profile of sugammadex for intense neuromuscular blockade reversal in children have been reported. This prospective study aimed to obtain a PK model of sugammadex and evaluate its efficacy and safety for intense neuromuscular blockade reversal in children. Forty children (age, 2–17 years) who underwent surgery that required early neuromuscular blockade reversal were enrolled. After neuromuscular blockade with 1 mg∙kg−1 of rocuronium, sugammadex (2, 4, and 8 mg∙kg−1) or a conventional dose of neostigmine (0.03 mg∙kg−1) was administered randomly after confirmation of zero post‐tetanic count. The plasma concentrations of rocuronium and sugammadex were measured 2 min after rocuronium injection; immediately before, 2, 5, 15, 60, 120, 240, and 480 min after the study drug injection. Response to train‐of‐four stimulation was continuously recorded. Noncompartmental analysis and population PK modeling were performed. For pharmacodynamics, the recovery profile was measured. Three‐compartment PK model was established for sugammadex. The median (interquartile range [IQR]) time from injection of 8 mg∙kg−1 of sugammadex to recovery of T4/T1greater than or equal to 0.9 at train‐of‐four stimulation was 1.1 (IQR: 0.88–1.8) min. No adverse events related to sugammadex were observed. We present a PK analysis of sugammadex for rocuronium‐induced intense neuromuscular blockade reversal in children with its recovery profile. The time to recover T4/T1 greater than or equal to 0.9 at train‐of‐four stimulation with 8 mg∙kg−1 of sugammadex was less than 3 min and comparable to that in adults.https://doi.org/10.1111/cts.13429 |
| spellingShingle | Sang‐Hwan Ji Ki Young Huh Jaeseong Oh Hee‐Jeong Jeong Young‐Eun Jang Eun‐Hee Kim Ji‐Hyun Lee Jin‐Tae Kim Hee‐Soo Kim Reversal of rocuronium‐induced intense neuromuscular blockade by sugammadex in Korean children: A pharmacokinetic and pharmacodynamic analysis Clinical and Translational Science |
| title | Reversal of rocuronium‐induced intense neuromuscular blockade by sugammadex in Korean children: A pharmacokinetic and pharmacodynamic analysis |
| title_full | Reversal of rocuronium‐induced intense neuromuscular blockade by sugammadex in Korean children: A pharmacokinetic and pharmacodynamic analysis |
| title_fullStr | Reversal of rocuronium‐induced intense neuromuscular blockade by sugammadex in Korean children: A pharmacokinetic and pharmacodynamic analysis |
| title_full_unstemmed | Reversal of rocuronium‐induced intense neuromuscular blockade by sugammadex in Korean children: A pharmacokinetic and pharmacodynamic analysis |
| title_short | Reversal of rocuronium‐induced intense neuromuscular blockade by sugammadex in Korean children: A pharmacokinetic and pharmacodynamic analysis |
| title_sort | reversal of rocuronium induced intense neuromuscular blockade by sugammadex in korean children a pharmacokinetic and pharmacodynamic analysis |
| url | https://doi.org/10.1111/cts.13429 |
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