Sugammadex Given for Rocuronium-Induced Neuromuscular Blockade in Infants: A Retrospective Study

Abstract

Study Objective: To evaluate the efficacy and safety of sugammadex in reversing profound neuromuscular block induced by rocuronium in infant patients.

Design: Retrospective observational study.

Setting: University teaching hospital.

Patients: Twenty-six infants (2-12 months of age; 3-11 kg) with an American Society of Anesthesiologists classification I, II, or III who were scheduled to undergo neurosurgical procedures were included in the study.

Interventions: Anesthesia was induced with 5 mg/kg thiopental, 1 mu g/kg fentanyl and 0.6 mg/kg rocuronium. Sevoflurane was administered to all patients after intubation.

Methods: The neuromuscular block was monitored with acceleromyography using train-of-four (TOF) stimuli. Patients received additional doses of rocuronium to maintain a deep block during surgery. If profound neuromuscular block (TOF, 0) persisted at the end of the surgery, 3 mg/kg sugammadex was administered.

Measurements: The demographic data, surgeries, and anesthetic agents were recorded. The time from sugammadex administration to recovery of neuromuscular function (TOF ratio, >0.9) and complications during and after extubation were also recorded.

Main results: Twenty-six infants who had a deep neuromuscular block (TOF, 0) at the end of surgery received 3 mg/kg sugammadex. The mean recovery time of the T4/T1 ratio of 0.9 was 112 seconds. No clinical evidence of recurarization or residual curarization was observed.

Conclusions: The efficacy and safety of sugammadex were confirmed in infant surgical patients for reversal of deep neuromuscular block induced by rocuronium. (C) 2016 Elsevier Inc. All rights reserved.