Abstract
Steroidal neuromuscular blocking agents (NMBAs), such as rocuronium and vecuronium, are commonly used intraoperatively to facilitate endotracheal intubation, optimize surgical conditions, and facilitate controlled ventilation. Historically, NMBA antagonism involved the use of neostigmine, an acetylcholinesterase inhibitor, with glycopyrrolate, an anticholinergic agent. Sugammadex is a modified cyclodextrin that selectively encapsulates steroidal NMBAs, forming an inactive water-soluble complex that is renally excreted. Due to its renal clearance, providers are cautious regarding its use in patients with end-stage renal disease (ESRD) because of the potential for postoperative neuromuscular blockade reoccurrence.
A review of the literature produced recent studies comparing sugammadex administration in patients with renal failure and patients with normal renal function. The studies found a prolonged recovery and lower clearance of sugammadex in patients with ESRD, however, there were no significant differences in the incidence of neuromuscular blockade recurrence or adverse events between the 2 groups. Only 1 study determined that the current safety experience was insufficient to support the use of sugammadex in this population. The remaining studies, however, support the use of sugammadex in patients with ESRD and encourage its consideration in this population.
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, Renal Disease, Neuromuscular Blockade
Advisor
Herbinger, Lisa
Degree
Doctoral-Other
Degree Grantor
Samford University
Degree Year
2023
Recommended Citation
Michaelis, Taylor and Herbinger, Lisa, "Sugammadex use in adult surgical patients with end-stage renal disease" (2023). Group: Samford University Moffett & Sanders School of Nursing. 75.
https://www.sigmarepository.org/samford/75
Creative Commons License
This work is licensed under a Creative Commons Attribution 3.0 License.
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Review Type
None: Degree-based Submission
Acquisition
Self-submission
Date of Issue
2023-02-07
Full Text of Presentation
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