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1. Sugammadex for the Recovery of Neuromuscular Blockade in Adult Patients: Clinical Effectiveness and Cost-Effectiveness - An Update

Sugammadex for the Recovery of Neuromuscular Blockade in Adult Patients: Clinical Effectiveness and Cost-Effectiveness - An Update Sugammadex for the Recovery of Neuromuscular Blockade in Adult Patients: Clinical Effectiveness and Cost-Effectiveness - An Update | CADTH.ca Find the information you need Sugammadex for the Recovery of Neuromuscular Blockade in Adult Patients: Clinical Effectiveness and Cost-Effectiveness - An Update Sugammadex for the Recovery of Neuromuscular Blockade in Adult (...) Patients: Clinical Effectiveness and Cost-Effectiveness - An Update Last updated: June 3, 2019 Project Number: RA1037-000 Product Line: Research Type: Drug Report Type: Reference List Result type: Report Question What is the clinical effectiveness regarding the use of sugammadex for the recovery of neuromuscular blockade in adult patients? What is the cost-effectiveness regarding the use of sugammadex for the recovery of neuromuscular blockade in adult patients? Key Message Five systematic reviews

2019 Canadian Agency for Drugs and Technologies in Health - Rapid Review

2. Sugammadex for the Reversal of Neuromuscular Blockade in Surgical Patients: A Review of Clinical Effectiveness and Cost-Effectiveness

Sugammadex for the Reversal of Neuromuscular Blockade in Surgical Patients: A Review of Clinical Effectiveness and Cost-Effectiveness Sugammadex for the Reversal of Neuromuscular Blockade in Surgical Patients: A Review of Clinical Effectiveness and Cost-Effectiveness | CADTH.ca Find the information you need Sugammadex for the Reversal of Neuromuscular Blockade in Surgical Patients: A Review of Clinical Effectiveness and Cost-Effectiveness Sugammadex for the Reversal of Neuromuscular Blockade (...) in Surgical Patients: A Review of Clinical Effectiveness and Cost-Effectiveness Last updated: August 6, 2019 Project Number: RC1161-000 Product Line: Research Type: Drug Report Type: Summary with Critical Appraisal Result type: Report Question What is the comparative clinical effectiveness of rocuronium with sugammadex versus succinylcholine in patients undergoing surgery? What is the cost-effectiveness of sugammadex in patients undergoing surgery Key Message Three randomized controlled trials were

2019 Canadian Agency for Drugs and Technologies in Health - Rapid Review

3. Sugammadex for the Reversal of Rocuronium-Induced Neuromuscular Blockade in Surgical Patients: A Review of Clinical Effectiveness

Sugammadex for the Reversal of Rocuronium-Induced Neuromuscular Blockade in Surgical Patients: A Review of Clinical Effectiveness Sugammadex for the Reversal of Rocuronium-Induced Neuromuscular Blockade in Surgical Patients: A Review of Clinical Effectiveness | CADTH.ca Find the information you need Sugammadex for the Reversal of Rocuronium-Induced Neuromuscular Blockade in Surgical Patients: A Review of Clinical Effectiveness Sugammadex for the Reversal of Rocuronium-Induced Neuromuscular (...) Blockade in Surgical Patients: A Review of Clinical Effectiveness Last updated: August 21, 2019 Project Number: RC1177-000 Product Line: Research Type: Drug Report Type: Summary with Critical Appraisal Result type: Report Question What is the comparative clinical effectiveness of rocuronium with sugammadex versus rocuronium with neostigmine in patients undergoing surgery? Key Message Three systematic reviews and seven randomized controlled trials were identified regarding the comparative clinical

2019 Canadian Agency for Drugs and Technologies in Health - Rapid Review

4. Comparative effectiveness of sugammadex versus neostigmine for reversal of neuromuscular blockade following surgery in adult patients

Comparative effectiveness of sugammadex versus neostigmine for reversal of neuromuscular blockade following surgery in adult patients Comparative effectiveness of sugammadex versus neostigmine for reversal of neuromuscular blockade following surgery in adult patients Comparative effectiveness of sugammadex versus neostigmine for reversal of neuromuscular blockade following surgery in adult patients HAYES, Inc. Record Status This is a bibliographic record of a published health technology (...) assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation HAYES, Inc.. Comparative effectiveness of sugammadex versus neostigmine for reversal of neuromuscular blockade following surgery in adult patients . Lansdale: HAYES, Inc.. Directory Publication. 2016 Authors' objectives Sugammadex (SUG) is indicated for the reversal of neuromuscular blockade (NMB) induced by rocuronium bromide and vecuronium bromide during surgery. SUG selectively binds

2017 Health Technology Assessment (HTA) Database.

5. Sugammadex for Adults Undergoing Surgery: Clinical and Cost-Effectiveness and Guidelines

Sugammadex for Adults Undergoing Surgery: Clinical and Cost-Effectiveness and Guidelines Sugammadex for Adults Undergoing Surgery: Clinical and Cost-Effectiveness and Guidelines | CADTH.ca Find the information you need Sugammadex for Adults Undergoing Surgery: Clinical and Cost-Effectiveness and Guidelines Sugammadex for Adults Undergoing Surgery: Clinical and Cost-Effectiveness and Guidelines Published on: January 4, 2016 Project Number: RA0841-000 Product Line: Research Type: Drug Report Type (...) : Reference List Result type: Report Question 1. What is the clinical effectiveness of sugammadex in adult patients undergoing surgery? 2. What is the cost-effectiveness of sugammadex in adult patients undergoing surgery? 3. What are the guidelines associated with the use of sugammadex in adult patients undergoing surgery? Key Message One health technology assessment, two systematic reviews, one systematic review with meta-analysis, 18 randomized controlled trials, and two economic evaluations were

2016 Canadian Agency for Drugs and Technologies in Health - Rapid Review

6. Sugammadex for the Reversal of Neuromuscular Blockade in Adult Patients: A Review of Clinical Effectiveness and Cost-Effectiveness

Sugammadex for the Reversal of Neuromuscular Blockade in Adult Patients: A Review of Clinical Effectiveness and Cost-Effectiveness Sugammadex for the Reversal of Neuromuscular Blockade in Adult Patients: A Review of Clinical Effectiveness and Cost-Effectiveness | CADTH.ca Find the information you need Sugammadex for the Reversal of Neuromuscular Blockade in Adult Patients: A Review of Clinical Effectiveness and Cost-Effectiveness Sugammadex for the Reversal of Neuromuscular Blockade in Adult (...) Patients: A Review of Clinical Effectiveness and Cost-Effectiveness Published on: May 26, 2016 Project Number: RC0781-000 Product Line: Research Type: Drug Report Type: Summary with Critical Appraisal Result type: Report Question What is the clinical effectiveness of sugammadex in adult patients? What is the cost-effectiveness of sugammadex in adult patients? Key Message Four systematic reviews and ten randomized controlled trials were identified relating to the clinical effectiveness of sugammadex

2016 Canadian Agency for Drugs and Technologies in Health - Rapid Review

7. Bridion (sugammadex) - To reverse effects of neuromuscular blocking drugs used during surgery

Bridion (sugammadex) - To reverse effects of neuromuscular blocking drugs used during surgery BRIDION (sugammadex) Injection U.S. Department of Health and Human Services Search FDA Submit search BRIDION (sugammadex) Injection BRIDION (sugammadex) Injection Company: Organon USA Inc. Application No.: 022225 Approval Date: 12/15/2015 Persons with disabilities having problems accessing the PDF files below may call (301) 796-3634 for assistance. (PDF) (PDF) (PDF) (PDF) (PDF) (PDF) (PDF) (PDF) (PDF

2015 FDA - Drug Approval Package

8. Diaphragmatic and intercostal electromyographic activity during neostigmine, sugammadex and neostigmine-sugammadex-enhanced recovery after neuromuscular blockade: A randomised controlled volunteer study. (Abstract)

Diaphragmatic and intercostal electromyographic activity during neostigmine, sugammadex and neostigmine-sugammadex-enhanced recovery after neuromuscular blockade: A randomised controlled volunteer study. Electromyographic activity of the diaphragm (EMGdi) during weaning from mechanical ventilation is increased after sugammadex compared with neostigmine.To determine the effect of neostigmine on EMGdi and surface EMG (sEMG) of the intercostal muscles during antagonism of rocuronium block (...) with neostigmine, sugammadex and neostigmine followed by sugammadex.Randomised, controlled, double-blind study.Intensive care research unit.Eighteen male volunteers.A transoesophageal EMGdi recorder was inserted into three groups of six anaesthetised study participants, and sEMG was recorded on their intercostal muscles. To reverse rocuronium, volunteers received 50 μg kg neostigmine, 2 mg kg sugammadex or 50 μg kg neostigmine, followed 3 min later by 2 mg kg sugammadex.We examined the EMGdi and sEMG

2017 European Journal of Anaesthesiology Controlled trial quality: predicted high

9. Half dose sugammadex combined with neostigmine is non-inferior to full dose sugammadex for reversal of rocuronium-induced deep neuromuscular blockade: a cost-saving strategy. Full Text available with Trip Pro

Half dose sugammadex combined with neostigmine is non-inferior to full dose sugammadex for reversal of rocuronium-induced deep neuromuscular blockade: a cost-saving strategy. Sugammadex reverses the effect of rocuronium more rapidly and effectively than neostigmine, at all levels of neuromuscular blockade (NMB). However, its cost is prohibitive. The combination of half dose sugammadex with neostigmine would be non-inferior to full dose sugammadex for the reversal of deep NMB. This approach (...) would reduce the cost of sugammadex while preserving its efficacy.Patients were randomly allocated to receive sugammadex 4 mg/kg (Group S) or sugammadex 2 mg/kg with neostigmine 50 μg/kg and glycopyrrolate 10 μg/kg (Group NS) for reversal of rocuronium deep NMB. The primary outcome was the percentage of patients who recovered to 90% Train of Four (TOF) ratio within 5 min. The non-inferiority margin was set at 10%.Twenty eight patients were enrolled in each group. The number of patients who reached

2017 BMC Anesthesiology Controlled trial quality: predicted high

10. Retrospective Analysis of the Safety and Efficacy of Sugammadex Versus Neostigmine for the Reversal of Neuromuscular Blockade in Children. (Abstract)

Retrospective Analysis of the Safety and Efficacy of Sugammadex Versus Neostigmine for the Reversal of Neuromuscular Blockade in Children. Sugammadex, with its novel mechanism of action of encapsulation and noncompetitive binding of aminosteroid neuromuscular-blocking agents (rocuronium and vecuronium), may offer distinct advantage to pediatric patients where residual neuromuscular blockade may be poorly tolerated. Data describing its use in the pediatric population are limited, and no large (...) -scale studies are available evaluating the occurrence of adverse event across the full spectrum of ages. We sought to measure the occurrence of adverse events, assess the severity and clinical significance of the events, and quantify a surrogate measure of efficacy of sugammadex compared to neostigmine in a large population and in the full age range of children.Beginning in September 2016 through initiation of data collection, we identified from our data warehouse that all patients were treated

2019 Anesthesia and Analgesia

11. A comparison of intravenous sugammadex and neostigmine + atropine reversal on time to consciousness during wake-up tests in spinal surgery. (Abstract)

A comparison of intravenous sugammadex and neostigmine + atropine reversal on time to consciousness during wake-up tests in spinal surgery. The effect of sugammadex on consciousness is not yet fully understood. This prospective, randomized, double-blind, multicenter study was performed to compare the effects of intravenous (IV) sugammadex and neostigmine + atropine reversals on time-to-consciousness during intraoperative wake-up tests in patients undergoing spinal surgery.A total of 66 American (...) Society of Anesthesiologists I-II patients aged 10-25 years undergoing spinal surgery were recruited. In all patients, bispectral index (BIS), motor-evoked potential (MEP), somatosensory-evoked potentials (SSEP), and train-of-four (TOF) scores were monitored. Patients received the same total IV anesthesia protocol with a propofol-remifentanil mixture. Patients were randomly allocated into two groups. During wake-up test, when the TOF count reached 2 (T2), either sugammadex 2 mg.kg-1 in group S

2019 Nigerian journal of clinical practice Controlled trial quality: uncertain

12. [Sugammadex by ideal body weight versus 20% and 40% corrected weight in bariatric surgery - double-blind randomized clinical trial]. Full Text available with Trip Pro

[Sugammadex by ideal body weight versus 20% and 40% corrected weight in bariatric surgery - double-blind randomized clinical trial]. The weight parameters for use of sugammadex in morbidly obese patients still need to be defined.A prospective clinical trial was conducted with sixty participants with body mass index≥40kg.m-2 during bariatric surgery, randomized into three groups: ideal weight (IW), 20% corrected body weight (CW20) and 40% corrected body weight (CW40). All patients received total (...) intravenous anesthesia. Rocuronium was administered at dose of 0.6mg.kg-1 of Ideal weight for tracheal intubation, followed by infusion of 0.3-0.6mg.kg-1.h-1. Train of four (TOF) was used to monitor depth of blockade. After spontaneous recovery TOF-count 2 at the end of surgery, 2mg.kg-1 of sugammadex was administered. Primary outcome was neuromuscular blockade reversal time to TOF≥0.9. Secondary outcome was the occurrence of postoperative residual curarization in post-anesthesia recovery room, searching

2019 Revista brasileira de anestesiologia Controlled trial quality: uncertain

13. Reversibility of Rocuronium-Induced Deep Neuromuscular Block with Sugammadex in Infants and Children-A Randomized Study. Full Text available with Trip Pro

Reversibility of Rocuronium-Induced Deep Neuromuscular Block with Sugammadex in Infants and Children-A Randomized Study. Sugammadex 4 mg·kg-1 is recommended for reversal from rocuronium-induced deep neuromuscular block. However, there is limited data regarding the dose-response of sugammadex required for reversal from deep neuromuscular block in pediatric patients. The aim of this study was to determine the reversibility of rocuronium-induced deep neuromuscular block with sugammadex in infants (...) ) stimulation during sevoflurane and remifentanil anesthesia. When the first response to the PTC stimulus was detected, either 1, 2 or 4 mg·kg-1 sugammadex was administered and the time required for facilitated recovery to a TOF ratio of 0.9 following each dose was compared. The time [mean (S.D.)] from the administration of 1 mg·kg-1 sugammadex until recovery to a TOF ratio of 0.9 was significantly longer [129.1 (83.5) s, p < 0.001] than that with 2 and 4 mg·kg-1 sugammadex [70.3 (26.7) s and 68.2 (34.5) s

2019 Biological & pharmaceutical bulletin Controlled trial quality: uncertain

14. The effect of magnesium on the reversal of rocuronium-induced neuromuscular block with sugammadex: an ex vivo laboratory study. Full Text available with Trip Pro

The effect of magnesium on the reversal of rocuronium-induced neuromuscular block with sugammadex: an ex vivo laboratory study. Magnesium dose-dependently potentiates the effect of non-depolarizing neuromuscular blocking agents. We investigated whether the potentiation of rocuronium-induced blockade by magnesium reduces the effect of sugammadex in an ex-vivo environment and how this influences the safety margin of reversal.Phrenic nerve - hemidiaphragm tissue preparations were isolated from (...) ). Increasing magnesium from 1 mM to 1.5 mM during reversal of rocuronium-induced block increased the mean (95% CI) EC50 of sugammadex from 3.67 μM (3.43-3.92 μM) to 5.36 μM (5.18-5.53 μM), whereas mean (95% CI) effective concentrations for 95% effect (EC95) were not significantly different at 7.22 μM (6.09-8.54 μM) and 7.61 μM (7.05-8.20 μM), respectively (p = 0.542). When rocuronium-induced block was reversed to a train-of-four (TOF) ratio > 0.9, but with still visible fade, increasing magnesium from 1 mM

2019 BMC Anesthesiology

15. Effects of neuromuscular block reversal with sugammadex versus neostigmine on postoperative respiratory outcomes after major abdominal surgery: a randomized-controlled trial. (Abstract)

Effects of neuromuscular block reversal with sugammadex versus neostigmine on postoperative respiratory outcomes after major abdominal surgery: a randomized-controlled trial. Postoperative pulmonary complications may be better reduced by reversal of neuromuscular block with sugammadex than by reversal with neostigmine because the incidence of residual block after sugammadex application is lower and diaphragm function is less impaired than after neostigmine administration. The aim of the study (...) was to compare the effect of reversal of neuromuscular block with sugammadex or neostigmine on lung function after major abdominal surgery.One hundred and thirty adults scheduled for major abdominal surgery under combined general and epidural anesthesia were randomly allocated to receive 40 µg of neostigmine or 4 mg·kg-1 of sugammadex to reverse neuromuscular block. Two blinded researchers performed spirometry and lung ultrasound before the surgery, as well as 1 hr and 24 hr postoperatively. Differences

2019 Canadian Journal Of Anaesthesia Controlled trial quality: predicted high

16. The effect of neuromuscular reversal agent on postoperative pain after laparoscopic gastric cancer surgery: Comparison between the neostigmine and sugammadex. Full Text available with Trip Pro

The effect of neuromuscular reversal agent on postoperative pain after laparoscopic gastric cancer surgery: Comparison between the neostigmine and sugammadex. Use of sugammadex for neuromuscular block reversal is associated with fewer postoperative complications than neostigmine; however, the effects on postoperative pain outcomes are largely unknown. In this retrospective study, we investigated the relationship between neuromuscular reversal agents and postoperative pain-related outcomes (...) following laparoscopic gastric cancer surgery.We reviewed the electronic health records of patients who underwent laparoscopic gastric cancer surgery between January 2010 and June 2017. Patients were divided into a sugammadex group and a neostigmine group, according to the neuromuscular block reversal agent used. We compared the pain outcomes in the first 3 days postoperatively (POD 0-3), length of hospital stay, and postoperative complications (Clavien-Dindo grade ≥II).During the study period, 3056

2019 Medicine

17. Effect of Sugammadex on Postoperative Myasthenic Crisis in Myasthenia Gravis Patients: Propensity Score Analysis of a Japanese Nationwide Database. (Abstract)

Effect of Sugammadex on Postoperative Myasthenic Crisis in Myasthenia Gravis Patients: Propensity Score Analysis of a Japanese Nationwide Database. In myasthenia gravis (MG) patients, postoperative myasthenic crisis, and residual neuromuscular blocking agent (NMBA) can cause respiratory failure that requires mechanical ventilation. However, it remains unclear whether the use of sugammadex for NMBA reversal reduces postoperative myasthenic crisis in MG patients undergoing surgery. We analyzed (...) the association between use of sugammadex and postoperative myasthenic crisis in patients with MG using a national inpatient database.Adult patients with MG who received thymectomy under general anesthesia were identified in the Japanese Diagnosis Procedure Combination database from July 1, 2010 to March 31, 2016. Patients who received sugammadex (sugammadex group) were compared with those who did not receive sugammadex (control group). The primary outcome was postoperative myasthenic crisis

2019 Anesthesia and Analgesia

18. Failure of reversion of neuromuscular block with sugammadex in patient with myasthenia gravis: case report and brief review of literature. Full Text available with Trip Pro

Failure of reversion of neuromuscular block with sugammadex in patient with myasthenia gravis: case report and brief review of literature. Myasthenia gravis (MG) is a challenge for anesthesia management. This report shows that the use of rocuronium-sugammadex is not free from flaws and highlights the importance of cholinesterase inhibitors management and neuromuscular block monitoring in the perioperative period of myasthenic patients.Myasthenic female patient submitted to general balanced (...) anesthesia using 25 mg of rocuronium. Under train-of-four (TOF) monitoring, repeated doses of sugammadex was used in a total of 800 mg without recovery of neuromuscular blockade, but TOF ratio (TOFR) was stabilized at 60%. Neostigmine administration led to the improvement of TOFR.Although the use of rocuronium-sugammadex seems safe, we should consider their unpredictability in myasthenic patients. This report supports the monitoring of neuromuscular blockade as mandatory in every patient, especially

2019 BMC Anesthesiology

19. [Comparison of the effects of sugammadex and neostigmine on postoperative nausea and vomiting]. Full Text available with Trip Pro

[Comparison of the effects of sugammadex and neostigmine on postoperative nausea and vomiting]. The aim of our study is to compare the effects of sugammadex and neostigmine, used for neuromuscular blockage antagonism, on postoperative nausea and vomiting (PONV).Our study was completed with 98 ASA I-II risk patients undergoing endotracheal intubation under general anesthesia. At the end of the surgery patients were randomly allocated into two groups given 2mgkg-1 sugammadex (Group S) or 50μgkg-1 (...) ), however the number of patients given ondansetron for PONV treatment in Group N was significantly higher than the number in Group S (16 in Group N, 6 in Group S, p<0.011).At the end of our study comparing neostigmine with sugammadex for neuromuscular blockage antagonism, we found use of sugammadex had lower incidence of PONV in the postoperative 1st hour and less anti-emetic use in 24hours of monitoring.Copyright © 2016 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All

2019 Revista brasileira de anestesiologia Controlled trial quality: uncertain

20. Influence of reversal of neuromuscular blockade with sugammadex or neostigmine on postoperative quality of recovery following a single bolus dose of rocuronium: A prospective, randomized, double-blinded, controlled study. Full Text available with Trip Pro

Influence of reversal of neuromuscular blockade with sugammadex or neostigmine on postoperative quality of recovery following a single bolus dose of rocuronium: A prospective, randomized, double-blinded, controlled study. To evaluate the influence of reversal of neuromuscular blockade with sugammadex or neostigmine on postoperative quality of recovery following a single bolus dose of rocuronium after pars plana vitrectomy (PPV) under general anesthesia.Prospective, double-blind, randomized (...) controlled trial.This study was conducted in a University Teaching Hospital from February to July 2017.A total of 84 patients with an American Society of Anesthesiologists physical status of I or II who were scheduled to undergo PPV under general anesthesia.The patients were randomly assigned to the neostigmine (Group N, n = 44) or sugammadex (Group S, n = 40) groups; 3 ml of study drug was prepared for the patients. For patients in Group N, a solution of neostigmine methylsulfate (1 mg

2019 Journal of clinical anesthesia Controlled trial quality: predicted high

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