Sugammadex ED90 dose to reverse the rocuronium neuromuscular blockade in obese patients
ABSTRACT Objective: to determine the ED90 (minimum effective dose in 90% of patients) of sugammadex for the reversal of rocuronium-induced moderate neuromuscular blockade (NMB) in patients with grade III obesity undergoing bariatric surgery. Methods: we conducted a prospective study with the bia...
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Colégio Brasileiro de Cirurgiões
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| Series: | Revista do Colégio Brasileiro de Cirurgiões |
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| author | MAURO PRADO DA SILVA CHRISTIANO MATSUI DANIEL DONGIOU KIM JOAQUIM EDSON VIEIRA CARLOS ALBERTO MALHEIROS LIGIA ANDRADE SILVA TELLES MATHIAS |
| author_facet | MAURO PRADO DA SILVA CHRISTIANO MATSUI DANIEL DONGIOU KIM JOAQUIM EDSON VIEIRA CARLOS ALBERTO MALHEIROS LIGIA ANDRADE SILVA TELLES MATHIAS |
| author_sort | MAURO PRADO DA SILVA |
| collection | DOAJ |
| description | ABSTRACT Objective: to determine the ED90 (minimum effective dose in 90% of patients) of sugammadex for the reversal of rocuronium-induced moderate neuromuscular blockade (NMB) in patients with grade III obesity undergoing bariatric surgery. Methods: we conducted a prospective study with the biased coin up-and-down sequential design. We chosen the following doses: 2.0mg/Kg, 2.2mg/Kg, 2.4mg/Kg, 2.6mg/Kg, 2.8mg/Kg. The complete reversal of rocuronium-induced NMB considered a T4/T1 ratio ≥0.9 as measured by TOF. After induction of general anesthesia and calibration of the peripheral nerve stimulator and accelerometer, we injected rocuronium 0.6mg/kg. We administered propofol and remifentanil by continuous infusion, and intermittent boluses of rocuronium throughout the procedure. Results: we evaluated 31 patients, of whom 26 had displayed successful reversal of the NMB with sugammadex, and failure in five. The mean time to complete moderate NMB reversal was 213 seconds (172-300, median 25-75%). The ED90 of sugammadex calculated by regression was 2.39mg/kg, with a 95% confidence interval of 2.27-2.46 mg/kg. Conclusion: the ED90 of sugammadex in patients with grade III obesity or higher was 2.39mg/kg. |
| first_indexed | 2024-12-13T09:51:03Z |
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| institution | Directory Open Access Journal |
| issn | 1809-4546 |
| language | English |
| last_indexed | 2024-12-13T09:51:03Z |
| publisher | Colégio Brasileiro de Cirurgiões |
| record_format | Article |
| series | Revista do Colégio Brasileiro de Cirurgiões |
| spelling | doaj.art-b99538c1f0f740e483b57d105e8071f12022-12-21T23:51:55ZengColégio Brasileiro de CirurgiõesRevista do Colégio Brasileiro de Cirurgiões1809-4546441414510.1590/0100-69912017001010S0100-69912017000100041Sugammadex ED90 dose to reverse the rocuronium neuromuscular blockade in obese patientsMAURO PRADO DA SILVACHRISTIANO MATSUIDANIEL DONGIOU KIMJOAQUIM EDSON VIEIRACARLOS ALBERTO MALHEIROSLIGIA ANDRADE SILVA TELLES MATHIASABSTRACT Objective: to determine the ED90 (minimum effective dose in 90% of patients) of sugammadex for the reversal of rocuronium-induced moderate neuromuscular blockade (NMB) in patients with grade III obesity undergoing bariatric surgery. Methods: we conducted a prospective study with the biased coin up-and-down sequential design. We chosen the following doses: 2.0mg/Kg, 2.2mg/Kg, 2.4mg/Kg, 2.6mg/Kg, 2.8mg/Kg. The complete reversal of rocuronium-induced NMB considered a T4/T1 ratio ≥0.9 as measured by TOF. After induction of general anesthesia and calibration of the peripheral nerve stimulator and accelerometer, we injected rocuronium 0.6mg/kg. We administered propofol and remifentanil by continuous infusion, and intermittent boluses of rocuronium throughout the procedure. Results: we evaluated 31 patients, of whom 26 had displayed successful reversal of the NMB with sugammadex, and failure in five. The mean time to complete moderate NMB reversal was 213 seconds (172-300, median 25-75%). The ED90 of sugammadex calculated by regression was 2.39mg/kg, with a 95% confidence interval of 2.27-2.46 mg/kg. Conclusion: the ED90 of sugammadex in patients with grade III obesity or higher was 2.39mg/kg.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69912017000100041&lng=en&tlng=enDose-Response RelationshipDrug. Obesity. Cyclodextrins |
| spellingShingle | MAURO PRADO DA SILVA CHRISTIANO MATSUI DANIEL DONGIOU KIM JOAQUIM EDSON VIEIRA CARLOS ALBERTO MALHEIROS LIGIA ANDRADE SILVA TELLES MATHIAS Sugammadex ED90 dose to reverse the rocuronium neuromuscular blockade in obese patients Revista do Colégio Brasileiro de Cirurgiões Dose-Response Relationship Drug. Obesity. Cyclodextrins |
| title | Sugammadex ED90 dose to reverse the rocuronium neuromuscular blockade in obese patients |
| title_full | Sugammadex ED90 dose to reverse the rocuronium neuromuscular blockade in obese patients |
| title_fullStr | Sugammadex ED90 dose to reverse the rocuronium neuromuscular blockade in obese patients |
| title_full_unstemmed | Sugammadex ED90 dose to reverse the rocuronium neuromuscular blockade in obese patients |
| title_short | Sugammadex ED90 dose to reverse the rocuronium neuromuscular blockade in obese patients |
| title_sort | sugammadex ed90 dose to reverse the rocuronium neuromuscular blockade in obese patients |
| topic | Dose-Response Relationship Drug. Obesity. Cyclodextrins |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69912017000100041&lng=en&tlng=en |
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