摘要：The effect of neuromuscular blocking agents (NMBAs) is characterized by a wide variability．Such variability is partly due to the differences in the pharmacological properties of the various relaxants used,partly due to differences in patien tcharacteristics(age，gender，bodycomposition，concurrent diseases and mediation etc)，and partly to the type and depth of the anesthetic administered．Variability in effect leads to unpredictable duration of neuromuscular blockade．Many studieshave，despite a shift toward the use of inteimediately long-acting relaxants，demonstrated that residual paralysis is present at the end of surgery and in the recovery room.1 It also has been demonstrated that residual paralysis leads to increased postoperative morbidity and mortality.2,3 Therefore many anesthetists routinely reverse neuromuscular blockade with the cholinesterase inhibitors neostigmine or pyndostigmine.4 However,routine reversal with cholinesterase inhibitors is not a guarantee for complete recovery and therefore also quantitative monitoring of the neuromuscular transmission is requested．Such monitoring however is not practiced in all hospitals．Besides，neostigmine and pyridostimnine cause many adverse reactions which demand the administration of atropine or glycopyrrolate.5 Also these drugs，especially atropine，Can result in adverse effects．Therefore it has been looked for reversal alternatives.6 Such an alternative is the encapsulation of the relaxant by cyclodextrines．From this approach sugammadex has been developed．It Was studied in animals and subsequently in humans．7-15 It demonstratedt0 be a safe and effective reversal agentthat will reverse neuromuscular blockade from steroidal muscle relaxants，but is ineffective whenbenzylisoquinoline derivatives are used．
