Anesthesia: Essays and Researches  Login  | Users Online: 577 Home Print this page Email this page Small font sizeDefault font sizeIncrease font size
Home | About us | Editorial board | Ahead of print | Search | Current Issue | Archives | Submit article | Instructions | Copyright form | Subscribe | Advertise | Contacts

Table of Contents  
Year : 2013  |  Volume : 7  |  Issue : 3  |  Page : 302-306  

Sugammadex: A revolutionary drug in neuromuscular pharmacology

1 Department of Anaesthesiology and Critical Care, Mahatma Gandhi Medical College, Pillaiyarkuppam, Puducherry, India
2 Department of Anaesthesiology, Krishna Institute of Medical Sciences, Karad, Maharashtra, India

Date of Web Publication18-Dec-2013

Correspondence Address:
Dewan Roshan Singh
Department of Anaesthesiology and Critical Care, Mahatma Gandhi Medical College, Pillaiyarkuppam, Puducherry - 607 402
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0259-1162.123211

Rights and Permissions

Sugammadex (ORG 25969) is a unique neuromuscular reversal drug; a novel cyclodextrin, the first in a new class of selective relaxant binding agents, which reverse neuromuscular blockade (NMB) with the aminosteroid non-depolarizing muscle relaxants rocuronium and vecuronium. Sugammadex can reverse moderate or deep NMB. The clinical use of sugammadex promises to eliminate many of the shortcomings in current anesthetic practice with regard to antagonism of rocuronium and other aminosteroid muscle relaxants.

Keywords: Encapsulation, residual paralysis, rocuronium, selective relaxant binding agent, sugammadex

How to cite this article:
Nag K, Singh DR, Shetti AN, Kumar H, Sivashanmugam T, Parthasarathy S. Sugammadex: A revolutionary drug in neuromuscular pharmacology. Anesth Essays Res 2013;7:302-6

How to cite this URL:
Nag K, Singh DR, Shetti AN, Kumar H, Sivashanmugam T, Parthasarathy S. Sugammadex: A revolutionary drug in neuromuscular pharmacology. Anesth Essays Res [serial online] 2013 [cited 2021 Dec 6];7:302-6. Available from:

   Introduction Top

Muscle relaxants are used during intraoperative period to facilitate endotracheal intubation, ensure patient immobility and improve surgical exposure. [1] Reversal agents are used to terminate the action of muscle relaxants. The ideal reversal agent should have a fast onset; should be efficient at any time, even soon after paralyzing the patient; it should be able to provide complete reversal either for light or profound blockade; it should have a longer half-life than the muscle relaxants and it should not have any side-effects. The ideal reversal agent is yet to be found, but sugammadex is very close to being an ideal reversal agent. [2] Sugammadex is a synthetic cyclodextrin molecule, which acts by encapsulation of rocuronium. [3],[4],[5],[6] The discovery of encapsulation for reversal of aminosteroid muscle relaxants is the result of work done by Bom, a research scientist at Organon International (Oss, Netherlands). [7],[8],[9] Literature search for the article was carried out using Google Scholar, Proquest database and on wikepedia using the term "Sugammadex."

   Chemical Structure Top

Sugammadex [6A,6B,6C,6D,6E,6F,6G,6H-octakis-S- (2-carboxyethyl)-6A,6B,6C,6D,6E,6F,6G,6H- octathio-γ-cyclodextrin octasodium salt] is a modified γ-cyclodextrin [Figure 1]. Chemical formula is C 72 H 104 Na 8 O 48 S 8. "Su" stands for sugar and "gammadex" stands for structural molecule gamma-cyclodextrin. [1] Cyclodextrins are cyclic dextrose units joined through 1-4 glycosyl bonds that are produced from starch or starch derivates using cyclodextrin glycosyltransferase. The three natural unmodified cyclodextrins are α-, β-or γ-cyclodextrin. Compared with α-and β-cyclodextrins, γ-cyclodextrin exhibits more favorable properties in terms of the size of its internal cavity, water solubility and bioavailability. To have a better fit of the larger rigid structure of the aminosteroid muscle relaxant molecule (e.g., rocuronium or vecuronium) within the cavity of γ-cyclodextrin, the latter was modified by adding eight side chains to extend the cavity. This modification allowed the four hydrophobic steroidal rings of rocuronium to be better accommodated within the hydrophobic cavity. In addition, adding negatively charged carboxyl groups at the end of the eight side chains served two purposes. First, the repellent forces of the negative charges keep propionic acid side chains from being disordered, thereby allowing the cavity to remain open and maintain structural integrity. Second, adding these negatively charged carboxyl groups enhances electrostatic binding to the positively charged quaternary nitrogen of rocuronium [Figure 1]. Three-dimensional structure resembles a hollow, truncated cone or a doughnut. [9]
Figure 1: Structure of sugammadex

Click here to view

Mechanism of action

Inactivates rocuronium by encapsulating (chelating) the free molecule to form a stable complex. [10] The structure has a hydrophobic cavity and a hydrophilic exterior because of the presence of polar hydroxyl groups. Hydrophobic interactions trap the drug into the cyclodextrin cavity, resulting in the formation of a water-soluble guest-host complex. Sugammadex exerts its effect by forming very tight complexes at a 1:1 ratio with aminosteroid muscle relaxants (rocuronium > vecuronium >> pancuronium). [9],[10],[11],[12] The intermolecular (van der Waals') forces, thermodynamic (hydrogen) bonds and hydrophobic interactions make the sugammadex-rocuronium complex very tight. The sugammadex-rocuronium complex has a very high association rate (an association constant of 107 M-1) and a very low dissociation rate. It is estimated that, for every 25 million sugammadex-rocuronium complexes, only one complex dissociates. The resulting reduction in free rocuronium plasma concentration creates a gradient between the tissue compartment (including the NMJ) and plasma; free rocuronium moves from tissue to plasma, with a reduction in nicotinic receptor occupancy at the NMJ. [10],[13],[14]


The volume of distribution of sugammadex is approximately 18 L and volume of distribution at steady state is 11-14 L (0.16-0.20 L/kg). The drug does not bind to plasma proteins or red blood cells. [2]

Metabolism and elimination

The drug does not produce any metabolites and is mostly excreted through urine in the unchanged form within 24 h. An insignificant part is excreted through feces or in expired air (0.02%). The plasma clearance of the drug ranges from 84 to 138 ml/min. [2]

Dosage and formulation

Minimum effective reversal dose: 2 mg/kg IV. [12]

Administration: The drug should be given as a single IV bolus, delivered within 10 s. [13]

The drug is available in IV formulation only; vials of 200 mg (2 ml) or 500 mg (5 ml) and is for non-refrigerated storage. [19] The drug was originally designated as Org 25,969. Trade name is Bridion. Sugammadex was discovered at the Newhouse research site in Scotland. Scientists who discovered Sugammadex worked for the pharmaceutical company, Organon. Organon was acquired by Schering-Plough in 2007; Schering-Plough merged with Merck in 2009. Sugammadex is now owned and sold by Merck. On January 3, 2008, Schering-Plough submitted a New Drug Application to the US FDA for sugammadex, but was rejected on August 2008. [20],[21] It was approved for use in the European Union on July 29, 2008. [17] The drug is also approved for use in Australia, Iceland, New Zealand and Norway.


Reversal of neuromuscular blockade (NMB) in the operation theater and in the intensive care unit (ICU). [17]

Drug interactions

Toremifene, a chemotherapeutic drug, which is a selective estrogen receptor modulator, can delay the reversal by displacing the formation of the rocuronium-sugammadex complex. The drug can theoretically bind with contraceptive steroids. As endogenous steroids and steroidal drugs lack the quaternary nitrogen of the aminosteroid muscle relaxants, they show a much lower affinity. Rocuronium-sugammadex complex can also be displaced by fusidic acid or high doses of flucloxacillin. Drugs like magnesium, aminoglycosides potentiate muscle relaxants; to counteract these effects, a larger dose of sugammadex may be required. Among anesthetic drugs the highest affinity constant was observed with remifentanil (0.2% of the affinity constant of sugammadex with rocuronium); it has not been shown to be clinically significant. Physical incompatibility has been reported with verapamil, ondansetron and ranitidine. Further investigations are required to assess other possible drug interactions. [1],[2],[9]

Sugammadex does not alter laboratory tests in general, but some modification of the serum progesterone assay and of the coagulation parameters like activated partial thromboplastin time, prothrombin time, INR has been noticed. [17]


Hypersensitivity to sugammadex or to any excipients. [13]

Special considerations

Patients with severe renal impairment: Clearance of the drug is reduced in patients with creatinine clearance below 30 ml/min. The efficacy of the drug is not reduced in these patients. [22] There are conflicting reports of its safety in these subset of patients; hence, it is recommended to avoid its use in such patients. [2]

Patients with hepatic impairment: Sugammadex-rocuronium complex is not eliminated by hepatic metabolism; therefore, hepatic impairment does not affect its excretion. However, it is advised to be cautious regarding its use in these patients. [2]

Obese patients: Use adult dose based on actual body weight.

Patients in ICU: Sugammadex has not been investigated in patients receiving rocuronium or vecuronium in the ICU.

Elderly: Use adult dose although recovery times are slower.

Pediatric patients: Pharmacokinetic profile is quite similar to that of adults. There is no clinical trial in children below 2 years of age.

Pregnancy and lactation: Caution in pregnant women. Sugammadex can be used during lactation.

Sex, race and body weight: They have no effect on the use of sugammadex.


A phenomenon of recurrence of NMB may occur where the reversal agents wear off before a muscle relaxant is completely cleared. It has been demonstrated to occur only rarely with sugammadex and only when insufficient doses were administered. The underlying mechanism is thought to be related to redistribution of relaxant after reversal. It may occur for a limited range of sugammadex doses, which are sufficient for complex formation with relaxant in the central compartment, but insufficient for additional relaxant returning to the central compartment from peripheral compartments. [16],[17],[18],[19]

   Comparison with Neostigmine Top

Sugammadex acts by encapsulation of rocuronium, whereas neostigmine is an anticholinesterase. Neostigmine has a ceiling effect and when given at a deep level of NMB, can result in inadequate reversal. Neostigmine is also associated with adverse effects like autonomic disturbances including bradycardia, which can be particularly troublesome during extubation in patients for cardiothoracic surgery, nausea and vomiting; these adverse effects are not noticed with sugammadex. [9],[15],[18],[23],[24],[25]

   Limitations Top

The drug is expensive. The cost of reversal of NMB with sugammadex in a 75 kg person is £59.74 for 2 mg/kg, £119.28 for 4 mg/kg and £357.84 for 16 mg/kg compared to £0.71 for spontaneous recovery from suxamethonium. [26] However, studies have shown that use of sugammadex can be cost-effective by reduced incidence of post-operative residual paralysis reducing operative time, post-operative recovery stay and also decreased side-effects associated with the use of suxamethonium.

Adverse effects

Sugammadex is a well-tolerated and relatively free of adverse effects. Some of the adverse reported in some of the trials are dysgeusia (metal or bitter taste) mainly seen after doses of 32 mg/kg or higher, recurrence of block, movement of limbs or body or coughing during anesthesia, coughing, grimacing or suckling on the endotracheal tube, procedural hypotension. [17],[27],[28]


If re-administration of rocuronium or vecuronium is required a waiting time of 24 h is recommended. If NMB is required before the recommended waiting time has passed, a non-steroidal muscle relaxant should be used. Sugammadex should not be used to reverse block induced by non-steroidal blockers such as suxamethonium or benzylisoquinolinium compounds (because it cannot form inclusion complexes with these drugs) or aminosteroid muscle relaxants other than rocuronium or vecuronium. [9],[16]

   Advantages Top

  1. Use of sugammadex will decrease the incidence of residual muscle paralysis and hence improve patient safety [29]
  2. Anesthesiologists will not hesitate to give incremental doses of muscle relaxant if required towards the end of surgery
  3. High dose rocuronium for rapid sequence induction, i.e., 1.2 mg/kg can be used safely in cases of short duration.
  4. In case of need to rapidly terminate the effect of muscle relaxants, i.e., in cannot intubate cannot ventilate scenario, rocuronium would be preferred to suxamethonium
  5. No additional anticholinestrases or anticholinergics would be needed for reversal of residual NMB, thus avoiding unwanted cardiovascular effects and other adverse effects of the drugs. [24]

   Will Sugammadex bring a Final Demise of Suxamethonium? Top

Use of suxamethonium has declined in modern anesthetic practice. Suxamethonium has numerous adverse effects such as fasciculations, myalgia, hyperkalemia, heart rate changes and increased intragastric and intraocular pressures, malignant hyperthermia. Use of suxamethonium in children is not preferred due to the danger of hyperkalemic cardiac arrest in children with unrecognized muscular dystrophy. [30]

Suxamethonium is still used in difficult airway scenario, full stomach and in cases under general anesthesia of short duration. If sugammadex becomes widely available, rocuronium can be used as a better alternative in the above situations.

   Potential Impact of Sugammadex on Day To Day Anesthetic Practice Top

  1. Sugammadex cannot reverse NMB with benzylisoquinolinium group of muscle relaxants or with suxamethonium
  2. After sugammadex administration, reblock with rocuronium will be difficult and the dose required will be unpredictable. Benzylisoquinolinium group of muscle relaxants or suxamethonium should be used in such a scenario
  3. Sugammadex does not have equal affinity with all aminosteroid relaxants. Reversal of pancuronium will require large doses of sugammadex
  4. It is necessary to know the extent of NMB before sugammadex administration. Train of four (TOF) count or post tetanic count (PTC) may be sufficient to decide the dosage of sugammadex. Reversal of profound block with inadequate doses of sugammadex will result in incomplete reversal. TOF ratio will give an objective assessment to help determine if antagonism of residual block is actually required. [31],[32]

   Cnclusion Top

Sugammadex may potentially promote the increased use of non-depolarizing aminosteroid muscle relaxants, but economic constraints may prevent its wide spread use and poses great limitations to its use. [33] It will prove useful for very short surgeries when an intermediate acting NMB is used or when the dose, timing or administration of neostigmine is inadequate. Surgeons should no longer encounter inadequate muscle relaxation and anesthesiologists should no longer encounter patients whose NMB is difficult to reverse at the end of surgery. [34] It should eliminate the occurrence of postoperative residual NMB. Assurance of no residual paralysis may enable anesthesiologists to better evaluate the success or failure when attempting to wean and extubate patients who have received aminosteroid muscle relaxants. Side-effects like nausea/vomiting or unwanted autonomic adverse effects encountered with neostigmine will be eliminated. [35] Improvements in patient outcome must have a dollar value that offsets the cost of the drug. FDA has still not approved the use of sugammadex due to some concerns regarding allergic reactions. The drug is being extensively used in the EU and Australia at present. Sugammadex should not replace good clinical practice titration of muscle relaxants to clinical needs and objective monitoring of NMB in the OT or ICU. [36] The introduction of propofol two decades ago changed anesthetic practice, no other drug has had the same impact. Undoubtedly, sugammadex is a milestone and is likely to change the face of clinical neuromuscular pharmacology.

   References Top

1.Kovac AL. Sugammadex: The first selective binding reversal agent for neuromuscular block. J Clin Anesth 2009;21:444-53.  Back to cited text no. 1
2.Hemmerling TM, Zaouter C, Geldner G, Nauheimer D. Sugammadex: A short review and clinical recommendations for the cardiac anesthesiologist. Ann Card Anaesth 2010;13:206-16.  Back to cited text no. 2
[PUBMED]  Medknow Journal  
3.Bhaskar SB. Emergence from anaesthesia: Have we got it all smoothened out? Indian J Anaesth 2013;57:1-3.  Back to cited text no. 3
[PUBMED]  Medknow Journal  
4.Lee C, Jahr JS, Candiotti KA, Warriner B, Zornow MH, Naguib M. Reversal of profound neuromuscular block by sugammadex administered three minutes after rocuronium: A comparison with spontaneous recovery from succinylcholine. Anesthesiology 2009;110:1020-5.  Back to cited text no. 4
5.Gijsenbergh F, Ramael S, Houwing N, van Iersel T. First human exposure of Org 25969, a novel agent to reverse the action of rocuronium bromide. Anesthesiology 2005;103:695-703.  Back to cited text no. 5
6.Nicholson WT, Sprung J, Jankowski CJ. Sugammadex: A novel agent for the reversal of neuromuscular blockade. Pharmacotherapy 2007;27:1181-8.  Back to cited text no. 6
7.Cameron KS, Fletcher L, Clark JK, Zhang MQ, Orbons LPM. Chemical chelation as a novel method of NMB reversal characterization of the Org 25969 NMB complex: 15. 2001;18:99.  Back to cited text no. 7
8.Zhang MQ. Drug specific cyclodextrins: The future of rapid neuro-muscular block reversal? Drugs Future 2003;28:347-54.  Back to cited text no. 8
9.Naguib M. Sugammadex: Another milestone in clinical neuromuscular pharmacology. Anesth Analg 2007;104:575-81.  Back to cited text no. 9
10.Bom A, Bradley M, Cameron K, Clark JK, Van Egmond J, Feilden H, et al. A novel concept of reversing neuromuscular block: Chemical encapsulation of rocuronium bromide by a cyclodextrin-based synthetic host. Angew Chem Int Ed Engl 2002;41:266-70.  Back to cited text no. 10
11.Adam JM, Bennett DJ, Bom A, Clark JK, Feilden H, Hutchinson EJ, et al. Cyclodextrin-derived host molecules as reversal agents for the neuromuscular blocker rocuronium bromide: Synthesis and structure-activity relationships. J Med Chem 2002;45:1806-16.  Back to cited text no. 11
12.Tarver GJ, Grove SJ, Buchanan K, Bom A, Cooke A, Rutherford SJ, et al. 2-O-substituted cyclodextrins as reversal agents for the neuromuscular blocker rocuronium bromide. Bioorg Med Chem 2002;10:1819-27.  Back to cited text no. 12
13.Cameron KS, Clark JK, Cooper A, Fielding L, Palin R, Rutherford SJ, et al. Modified gamma-cyclodextrins and their rocuronium complexes. Org Lett 2002;4:3403-6.  Back to cited text no. 13
14.Epemolu O, Bom A, Hope F, Mason R. Reversal of neuromuscular blockade and simultaneous increase in plasma rocuronium concentration after the intravenous infusion of the novel reversal agent Org 25969. Anesthesiology 2003;99:632-7.  Back to cited text no. 14
15.Sparr HJ, Vermeyen KM, Beaufort AM, Rietbergen H, Proost JH, Saldien V, et al. Early reversal of profound rocuronium-induced neuromuscular blockade by sugammadex in a randomized multicenter study: Efficacy, safety, and pharmacokinetics. Anesthesiology 2007;106:935-43.  Back to cited text no. 15
16.Yang LP, Keam SJ. Sugammadex: A review of its use in anaesthetic practice. Drugs 2009;69:919-42.  Back to cited text no. 16
17.BRIDION(R) (Sugammadex) Injection-First and Only Selective Relaxant Binding Agent-Approved in European Union. Schering-Plough, 2008-07-29.  Back to cited text no. 17
18.Sacan O, White PF, Tufanogullari B, Klein K. Sugammadex reversal of rocuronium-induced neuromuscular blockade: A comparison with neostigmine-glycopyrrolate and edrophonium-atropine. Anesth Analg 2007;104:569-74.  Back to cited text no. 18
19.Kovac AL. Sugammadex: A selective relaxant binding agent for neuromuscular block reversal. Formulary 2009;44:13-21.  Back to cited text no. 19
20.US FDA Issues Action Letter for Sugammadex. Schering-Plough (press release), 2008-08-01.  Back to cited text no. 20
21.Naguib M, Mohamed, Brull, Sorin J. Update on neuromuscular pharmacology. Curr Opin Anaesthesiol 2009;26:874-84.  Back to cited text no. 21
22.Staals LM, Snoeck MM, Driessen JJ, Flockton EA, Heeringa M, Hunter JM. Multicentre, parallel-group, comparative trial evaluating the efficacy and safety of sugammadex in patients with end-stage renal failure or normal renal function. Br J Anaesth 2008;101:492-7.  Back to cited text no. 22
23.Dahl V, Pendeville PE, Hollmann MW, Heier T, Abels EA, Blobner M. Safety and efficacy of sugammadex for the reversal of rocuronium-induced neuromuscular blockade in cardiac patients undergoing noncardiac surgery. Eur J Anaesthesiol 2009;26:874-84.  Back to cited text no. 23
24.Hemmerling TM, Russo G, Bracco D. Neuromuscular blockade in cardiac surgery: An update for clinicians. Ann Card Anaesth 2008;11:80-90.  Back to cited text no. 24
[PUBMED]  Medknow Journal  
25.Jones RK, Caldwell JE, Brull SJ, Soto RG. Reversal of profound rocuronium-induced blockade with sugammadex: A randomized comparison with neostigmine. Anesthesiology 2008;109:816-24.  Back to cited text no. 25
26.Chambers D, Paulden M, Paton F, Heirs M, Duffy S, Hunter JM, et al. Sugammadex for reversal of neuromuscular block after rapid sequence intubation: A systematic review and economic assessment. Br J Anaesth 2010;105:568-75.  Back to cited text no. 26
27.Bajaj P. Reversal by sugammadex. Indian J Anaesth 2009;53:399-400.  Back to cited text no. 27
[PUBMED]  Medknow Journal  
28.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.  Back to cited text no. 28
29.Abrishami A, Ho J, Wong J, Yin L, Chung F. Cochrane corner: Sugammadex, a selective reversal medication for preventing postoperative residual neuromuscular blockade. Anesth Analg 2010;110:1239.  Back to cited text no. 29
30.Miller RD. Sugammadex: An opportunity to change the practice of anesthesiology? Anesth Analg 2007;104:477-8.  Back to cited text no. 30
31.Suy K, Morias K, Cammu G, Hans P, van Duijnhoven WG, Heeringa M, et al. Effective reversal of moderate rocuronium- or vecuronium-induced neuromuscular block with sugammadex, a selective relaxant binding agent. Anesthesiology 2007;106:283-8.  Back to cited text no. 31
32.Eleveld DJ, Kuizenga K, Proost JH, Wierda JM. A temporary decrease in twitch response during reversal of rocuronium-induced muscle relaxation with a small dose of sugammadex. Anesth Analg 2007;104:582-4.  Back to cited text no. 32
33.Ledowski T, Hillyard S, O'Dea B, Archer R, Vilas-Boas F, Kyle B. Introduction of sugammadex as standard reversal agent: Impact on the incidence of residual neuromuscular blockade and postoperative patient outcome. Indian J Anaesth 2013;57:46-51.  Back to cited text no. 33
[PUBMED]  Medknow Journal  
34.Tayal G, Kundra S, Grewal A. Sugammadex-New neuromuscular block reversal. J Anaesth Clin Pharmacol 2008;24:211-4.  Back to cited text no. 34
35.Naguib M, Magboul MM. Adverse effects of neuromuscular blockers and their antagonists. Drug Saf 1998;18:99-116.  Back to cited text no. 35
36.Duvaldestin P, Kuizenga K, Saldien V, Claudius C, Servin F, Klein J, et al. A randomized, dose-response study of sugammadex given for the reversal of deep rocuronium- or vecuronium-induced neuromuscular blockade under sevoflurane anesthesia. Anesth Analg 2010;110:74-82.  Back to cited text no. 36


  [Figure 1]

This article has been cited by
1 Molecular interactions in remdesivir-cyclodextrin systems
Bianka Várnai, Milo Malanga, Tamás Sohajda, Szabolcs Béni
Journal of Pharmaceutical and Biomedical Analysis. 2021; : 114482
[Pubmed] | [DOI]
2 Aggregation versus inclusion complexes to solubilize drugs with Cyclodextrins. A case study using sulphobutylether-ß-cyclodextrins and remdesivir
Ángel Piñeiro,James Pipkin,Vince Antle,Rebeca Garcia-Fandino
Journal of Molecular Liquids. 2021; : 117588
[Pubmed] | [DOI]
3 A systematic review and meta-analysis of the use of succinylcholine to facilitate tracheal intubation in neonates
Bhavna Gupta, Priyanka Mishra
Ain-Shams Journal of Anesthesiology. 2021; 13(1)
[Pubmed] | [DOI]
4 Comparison of deep and moderate neuromuscular blockade in microwave ablation of liver tumours: a randomized-controlled clinical trial
Pui San Loh,Chai Hong Yeong,Naeema S. Masohood,Norshazriman Sulaiman,Rafdzah Ahmad Zaki,Kamil Fabell,Basri Johan Jeet Abdullah
Scientific Reports. 2021; 11(1)
[Pubmed] | [DOI]
5 Uso de sugammadex en la porfiria aguda intermitente
João Silva-Duarte,Tiago Taleco,Daniela Rosinha,Rita Regufe,André Eloy,Joana Tinoco
Revista Mexicana de Anestesiología. 2021; 44(3): 229
[Pubmed] | [DOI]
6 Pseudocholinesterase Deficiency – Is Succinylcholine Still Needed to Facilitate Endotracheal Intubation?
Lakshmi N Kurnutala,Nickhil Rugnath
Cureus. 2020;
[Pubmed] | [DOI]
7 Sugammadex Administration in Pregnant Women and in Women of Reproductive Potential
Michael G. Richardson,Britany L. Raymond
Anesthesia & Analgesia. 2020; 130(6): 1628
[Pubmed] | [DOI]
8 Sugammadex and neuromuscular reversal: special focus on neonatal and infant populations
Eliot Grigg
Current Opinion in Anaesthesiology. 2020; 33(3): 374
[Pubmed] | [DOI]
9 Supramolecular neuromuscular blocker inhibition by a pillar[5]arene through aqueous inclusion of rocuronium bromide
Dmitriy N. Shurpik,Olga A. Mostovaya,Denis A. Sevastyanov,Oksana A. Lenina,Anastasiya S. Sapunova,Alexandra D. Voloshina,Konstantin A. Petrov,Irina V. Kovyazina,Peter J. Cragg,Ivan I. Stoikov
Organic & Biomolecular Chemistry. 2019; 17(46): 9951
[Pubmed] | [DOI]
10 Cyclodextrins: Emerging Medicines of the New Millennium
Susana Santos Braga
Biomolecules. 2019; 9(12): 801
[Pubmed] | [DOI]
11 Ultra-Rapid Reversal of Rocuronium-Induced Paralysis with Sugammadex in the Emergency Department
Makenna A. Smack,Meredith Moore,Chris Hong,Dante Gravino
Journal of Emergency Nursing. 2018; 44(5): 529
[Pubmed] | [DOI]
12 Sugammadex: Efficacy and Practicality in the Dental Office
Stephen Goetz,Benjamin Pritts,Bryant Cornelius. DDS
Anesthesia Progress. 2018; 65(2): 113
[Pubmed] | [DOI]
13 Comparison of Sugammadex and Neostigmine on First Spontaneous Breathing and Adverse Effects for Laparoscopic Cholecystectomy
HyunSuk Park,Moon Soo Park,Min Jung Kim,Kwi Suk Kim,Yoon Sook Cho,Seng Sim Bae,Sandy Jeong Rhie
Korean Journal of Clinical Pharmacy. 2018; 28(2): 101
[Pubmed] | [DOI]
14 DAMP-Inducing Adjuvant and PAMP Adjuvants Parallelly Enhance Protective Type-2 and Type-1 Immune Responses to Influenza Split Vaccination
Tomoya Hayashi,Masatoshi Momota,Etsushi Kuroda,Takato Kusakabe,Shingo Kobari,Kotaro Makisaka,Yoshitaka Ohno,Yusuke Suzuki,Fumika Nakagawa,Michelle S. J. Lee,Cevayir Coban,Risako Onodera,Taishi Higashi,Keiichi Motoyama,Ken J. Ishii,Hidetoshi Arima
Frontiers in Immunology. 2018; 9
[Pubmed] | [DOI]
15 Neuromuscular blocking agents induced anaphylaxis: Results and trends of a French pharmacovigilance survey from 2000 to 2012
N. Petitpain,L. Argoullon,K. Masmoudi,S. Fedrizzi,J. Cottin,C. Latarche,P. M. Mertes,P. Gillet
Allergy. 2018;
[Pubmed] | [DOI]
16 Sugammadex advice for women of childbearing age
R. Williams,H. Bryant
Anaesthesia. 2018; 73(1): 133
[Pubmed] | [DOI]
17 Effectiveness of sugammadex versus neostigmine on restoration of neuromuscular function in surgical patients with myasthenia gravis undergoing rocuronium-induced neuromuscular blockade
Elizabeth Yellott,Jennifer Badeaux,Jennifer Martin,Julie H. Schiavo
JBI Database of Systematic Reviews and Implementation Reports. 2018; 16(10): 1922
[Pubmed] | [DOI]
18 Postoperative complications with neuromuscular blocking drugs and/or reversal agents in obstructive sleep apnea patients: a systematic review
Khawaja Rashid Hafeez,Arvind Tuteja,Mandeep Singh,David T. Wong,Mahesh Nagappa,Frances Chung,Jean Wong
BMC Anesthesiology. 2018; 18(1)
[Pubmed] | [DOI]
19 From Oxiranes to Oligomers: Architectures of U.S. FDA Approved Pharmaceuticals Containing Oxygen Heterocycles
Michael D. Delost,David T. Smith,Benton J. Anderson,Jon T. Njardarson
Journal of Medicinal Chemistry. 2018;
[Pubmed] | [DOI]
20 Analysis of US FDA-Approved Drugs Containing Sulfur Atoms
Kevin A. Scott,Jon T. Njardarson
Topics in Current Chemistry. 2018; 376(1)
[Pubmed] | [DOI]
21 Areas of Research Interest in Airway Management: Direction and Gaps
Masood Mohseni
Annals of Anesthesiology and Critical Care. 2018; In Press(In Press)
[Pubmed] | [DOI]
22 Selected highlights in clinical anesthesia research
Mark C. Kendall,Zachary M. Robbins,Alexander Cohen,Mary Minn,Scott E. Benzuly,Andrew S. Triebwasser,Zachary L. McCormick,Michelle Gorgone
Journal of Clinical Anesthesia. 2017;
[Pubmed] | [DOI]


    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

  In this article
   Chemical Structure
    Comparison with ...
    Will Sugammadex ...
    Potential Impact...
    Article Figures

 Article Access Statistics
    PDF Downloaded595    
    Comments [Add]    
    Cited by others 22    

Recommend this journal