Document Detail

Can sugammadex save a patient in a simulated 'cannot intubate, cannot ventilate' situation?
MedLine Citation:
PMID:  21198485     Owner:  NLM     Status:  MEDLINE    
Recent studies have shown that the use of high dose rocuronium followed by sugammadex provides a faster time to recovery from neuromuscular blockade following rapid sequence induction than suxamethonium. In a manikin-based 'cannot intubate, cannot ventilate' simulation, we studied the total time taken for anaesthetic teams to prepare and administer sugammadex from the time of their initial decision to use the drug. The mean (SD) total time to administration of sugammadex was 6.7 (1.5) min, following which a further 2.2 min (giving a total 8.9 min) should be allowed to achieve a train-of-four ratio of 0.9. Four (22%) teams gave the correct dose, 10 (56%) teams gave a dose that was lower than recommended, four (22%) teams gave a dose that was higher than recommended, six (33%) teams administered sugammadex in a single dose, and 12 (67%) teams gave multiple doses. Our simulation highlights that sugammadex might not have saved this patient in a 'cannot intubate, cannot ventilate' situation, and that difficulties and delays were encountered when identifying, preparing and administering the correct drug dose.
M M A Bisschops; C Holleman; J M Huitink
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Anaesthesia     Volume:  65     ISSN:  1365-2044     ISO Abbreviation:  Anaesthesia     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2011-01-04     Completed Date:  2011-01-24     Revised Date:  2011-03-16    
Medline Journal Info:
Nlm Unique ID:  0370524     Medline TA:  Anaesthesia     Country:  England    
Other Details:
Languages:  eng     Pagination:  936-41     Citation Subset:  AIM; IM    
Copyright Information:
© 2010 The Authors. Journal compilation © 2010 The Association of Anaesthetists of Great Britain and Ireland.
Department of Anesthesiology, VU University Medical Centre, Amsterdam, Netherlands.
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MeSH Terms
Androstanols / antagonists & inhibitors*,  pharmacology
Dose-Response Relationship, Drug
Drug Administration Schedule
Intubation, Intratracheal / contraindications
Neuromuscular Blockade
Neuromuscular Junction / drug effects*
Neuromuscular Nondepolarizing Agents / antagonists & inhibitors*,  pharmacology
Respiration, Artificial / contraindications
gamma-Cyclodextrins / administration & dosage,  pharmacology*
Reg. No./Substance:
0/Androstanols; 0/Neuromuscular Nondepolarizing Agents; 0/Sugammadex; 0/gamma-Cyclodextrins; 143558-00-3/rocuronium
Comment In:
Anaesthesia. 2011 Feb;66(2):141-2   [PMID:  21254997 ]
Anaesthesia. 2011 Mar;66(3):224-5; author reply 225   [PMID:  21320095 ]
Anaesthesia. 2011 Mar;66(3):224   [PMID:  21320094 ]
Anaesthesia. 2011 Feb;66(2):139-40   [PMID:  21254994 ]
Anaesthesia. 2011 Mar;66(3):223-4   [PMID:  21320093 ]
Anaesthesia. 2011 Feb;66(2):140-1; author reply 141   [PMID:  21254995 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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