Abstract

Neuromuscular blocking agents are widely used during surgery to provide optimal conditions for endotracheal intubation and to provide surgical relaxation by inhibiting skeletal muscle movement. Although acetylcholinesterase inhibitors are the most common medications used to antagonize the effects of nondepolarizing neuromuscular blocking agents, residual blockade is a persistent problem. Incomplete recovery from neuromuscular blocking agents can result in critical postoperative adverse events (i.e., respiratory complications, airway obstruction, hypoxemia, etc.). Sugammadex, a modified gamma-cyclodextrin, could be the ideal reversal agent for steroidal nondepolarizing neuromuscular blocking agents such as rocuronium, vecuronium, and pancuronium, especially when a deep or profound block exists. Sugammadex works by selectively encapsulating aminosteroidal nondepolarizing neuromuscular blocking agents, thus reversing their neuromuscular blocking action. It is a safe, effective agent that can be used to reverse any level of neuromuscular blockade, and the fast onset allows for rapid airway control and can decrease the anesthesia recovery period. This selective binding agent is able to reliably reverse neuromuscular blockade without the unpredictable efficacy and adverse muscarinic side effects that are commonly associated with acetylcholinesterase inhibitors. Research shows reversal of neuromuscular blockade with sugammadex is overall superior to neostigmine as it induces rapid and predictable reversal of any level of neuromuscular block, decreases the occurrence of residual block in the postoperative period, and increases overall patient safety.

Emily Perry

Author Details

Emily Perry, DNP(c), RN

Sigma Membership

Non-member

Lead Author Affiliation

Samford University, Birmingham, Alabama, USA

Type

DNP Capstone Project

Format Type

Text-based Document

Study Design/Type

Case Study/Series

Research Approach

Translational Research/Evidence-based Practice

Keywords:

Sugammadex, Neostigmine, Neuromuscular Blockade Reversal

Advisor

Barnes, Christa Lauren

Second Advisor

Cahoon, Terri

Degree

DNP

Degree Grantor

Samford University

Degree Year

2021

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

All permission requests should be directed accordingly and not to the Sigma Repository.

All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

None: Degree-based Submission

Acquisition

Proxy-submission

Date of Issue

2021-03-24

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