Low-dose sugammadex reverses moderate rocuronium-induced neuromuscular block in horses.
Abstract: Neuromuscular block (NMB) during general anaesthesia has an implicit risk of inadvertent residual NMB during recovery. Reversal of NMB is commonly encouraged to decrease this risk, and has historically been performed with neostigmine/atropine, two agents with important cardiac and gastrointestinal side effects. Sugammadex is a new selective relaxant binding agent that can reverse rocuronium-induced NMB efficiently and without these complications. Recommended doses are possibly cost-prohibitive. Objective: To measure the recovery time from rocuronium-NMB after administration of low-dose sugammadex, compared with spontaneous recovery. Methods: Nonrandomised in vivo experiments. Methods: Fourteen adult horses undergoing different research procedures were anaesthetised with detomidine and isoflurane. All horses received NMB with rocuronium 0.3 mg/kg IV. Neuromuscular function was measured with acceleromyographic train-of-four (TOF) ratio. Recovery occurred spontaneously in five horses weighing (median [range]) 548 (413-594) kg and was enhanced with sugammadex 200 mg (total dose) in nine horses (433 [362-515]) kg. Recovery time from moderate NMB to a TOF ratio 1.0, and total duration of NMB were compared between groups. Cases of recurarisation (decrease in the TOF ratio <0.9 after recovery) were identified within 30 min after sugammadex. Results: The dose of sugammadex was 0.46 (0.39-0.55) mg/kg. The recovery period lasted 21 (17-39) minutes for spontaneous and 4 (3-7) minutes for sugammadex. Total duration of NMB was 58 (41-70) minutes for spontaneous and 36 (21-43) for sugammadex (both p ≤ 0.003). There were no instances of recurarisation. Conclusions: Small sample size. Conclusions: A dose of sugammadex of approximately 0.5 mg/kg substantially shortened the recovery period from rocuronium-induced NMB from a median of 21 to 4 min, when given at a moderate depth of NMB. No recurarisation was observed within the next 30 min.
© 2024 EVJ Ltd.
Publication Date: 2024-01-28 PubMed ID: 38281489DOI: 10.1111/evj.14066Google Scholar: Lookup
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Summary
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The research article focuses on the effects of using a low-dose medication, sugammadex, to reverse neuromuscular block (NMB) induced by rocuronium in horses. The study found that sugammadex significantly shortened the recovery time from NMB without any noted side effects.
Introduction and Objective of the Study
- The study focuses on the risks of Neuromuscular Block (NMB) during general anaesthesia in horses. Residual NMB can inadvertently occur during recovery, leading to potential complications.
- Traditionally, NMB reversal has been executed with neostigmine/atropine, but these agents have been associated with significant cardiac and gastrointestinal side effects.
- Sugammadex, a new selective binding agent, can efficiently reverse rocuronium-induced NMB without these side effects. However, its recommended doses might be costly.
- The main purpose of the study is to measure the recovery time from rocuronium-NMB following the administration of a low-dose of sugammadex and compare it to natural recovery time.
Methods and Procedures
- The study involved fourteen adult horses that were anaesthetised and administered NMB with 0.3 mg/kg IV of rocuronium.
- The researchers used acceleromyographic train-of-four (TOF) ratio to measure neuromuscular function.
- Spontaneous recovery occurred in five horses, while sugammadex treatment enhanced recovery in nine horses.
- The researchers studied the recovery time from moderate NMB to a TOF ratio 1.0 and compared the total duration of NMB between the two groups.
- They identified cases of recurarisation (decline in the TOF ratio less than 0.9 after recovery) within 30 minutes post sugammadex administration.
Findings of the Study
- The administered dose of sugammadex was 0.46 (0.39-0.55) mg/kg. The recovery duration was around 21 minutes for spontaneous recovery and approximately 4 minutes for sugammadex treated recovery.
- The total duration of NMB was 58 minutes for spontaneous recovery and 36 minutes for the sugammadex-treated group.
- No instances of recurarisation were detected in the study.
Conclusions
- Despite the small sample size, the study concludes that a dose of approximately 0.5 mg/kg of sugammadex notably shortened the recovery period from rocuronium-induced NMB, from approximately 21 to 4 minutes, when administered at a moderate depth of NMB.
- No instances of recurarisation were observed within the next 30 minutes post treatment.
Cite This Article
APA
Martin-Flores M, Sakai DM, Araos J, Campoy L.
(2024).
Low-dose sugammadex reverses moderate rocuronium-induced neuromuscular block in horses.
Equine Vet J.
https://doi.org/10.1111/evj.14066 Publication
Researcher Affiliations
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA.
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia, USA.
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA.
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA.
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