Sugammadex and cholinesterase inhibitors.

摘要

I read with interest the description of a case in which a patient received low dose sugammadex followed by the combination of neostigmine and atropine for reversal of a rocuronium-induced neuromuscular block (NMB). Reversal of profound NMB (PTC 4) with a suboptimal dose of sugammadex (2 mg/kg) was not successful and after a repeated dose of sugammadex, the train-of-four ratio was recovered to only 42%. At that point a combination of neostigmine and atropine was given to accelerate reversal. Although the reversal was successful, but slow, I would like to discuss a few points of concern.