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Sugammadex

(Bridion®)

Sugammadex

Drug updated on 4/16/2024

Dosage FormInjection (intravenous; 200 mg/2 mL, 500 mg/5 mL)
Drug ClassModified gamma cyclodextrin
Ongoing and
Completed Studies		ClinicalTrials.gov

Indication

  • Indicated for the reversal of neuromuscular blockade induced by rocuronium bromide and vecuronium bromide in adults and pediatric patients aged 2 years and older undergoing surgery.

Summary
This AI-generated content is provided without warranty and may be inaccurate or outdated; it should be used only as a research starting point, with no liability accepted for reliance on it. Learn more.

  • Sugammadex (Bridion) is indicated for the reversal of neuromuscular blockade induced by rocuronium bromide and vecuronium bromide in adults and pediatric patients aged 2 years and older undergoing surgery.
  • A total of 23 systematic reviews/meta-analyses were reviewed to gather information about this drug's safety, effectiveness, comparison with other drugs like neostigmine, as well as its use in various population subgroups including pediatric patients.
  • In terms of safety profile, sugammadex (Bridion) demonstrated a more favorable outcome compared to traditional regimens or placebos when used on children for reversing rocuronium-induced neuromuscular blockade; it had lower incidence rates of adverse effects.
  • There exists a rare but significant risk associated with sugammadex (Bridion), namely anaphylaxis which has been observed at incidence rates between 0.02% -0.04%, warranting further investigation despite these low occurrence rates.
  • Patients suffering from systemic mastocytosis can safely be administered sugammadex (Bridion), confirmed through tryptase level monitoring.
  • Compared against neostigmine, multiple studies have shown that using sugammadex (Bridion) results in lower risks related postoperative residual neuromuscular blockade and pulmonary complications such pneumonia or respiratory failure; it also showed reduced instances bradycardia along with postoperative nausea/vomiting.
  • Sugammadex(Bridon)'s efficacy was highlighted across adult/pediatric populations where it consistently outperformed traditional acetylcholinesterase inhibitors/neostigmine both speed/efficacy wise while reversing moderate/deep blocks thus reducing risk residual block/associated pulmonary complications.
  • In specific surgical contexts like colorectal surgery, sugammadex (Bridion) has shown to significantly enhance gastrointestinal motility postoperatively compared to acetylcholinesterase inhibitors; however its impact on surgical morbidity and hospital stay length remains similar between the groups.

Product Monograph / Prescribing Information

Document TitleYearSource
Bridion (sugammadex) Prescribing Information.2022Merck Sharp & Dohme LLC Rahway, NJ

Systematic Reviews / Meta-Analyses

Document TitleYearSource
Sugammadex for reversing neuromuscular blockages after lung surgery: A systematic review and meta-analysis2023Journal of clinical medicine
Efficacy and safety of sugammadex sodium in reversing rocuronium-induced neuromuscular blockade in children: An updated systematic review and meta-analysis2023Heliyon
Should rocuronium and sugammadex replace succinylcholine for airway emergencies in class B ambulatory anesthesia settings?2023Minerva anestesiologica
Superiority of sugammadex in preventing postoperative pulmonary complications2023Chinese medical journal
The effect of sugammadex versus neostigmine on postoperative nausea and vomiting: a meta-analysis of randomized controlled trials with trial sequential analysis2023Current drug safety
Reversal of neuromuscular block with sugammadex compared with neostigmine and postoperative pulmonary complications in obese patients: meta-analysis and trial sequential analysis2023British journal of anaesthesia
Sugammadex Reduced the Incidence of Postoperative Pulmonary Complications in Susceptible Patients Identified by ARISCAT Risk Index: Systematic Review and Meta-analysis2023Advances in therapy
Appropriate dosing of sugammadex for reversal of rocuronium-/vecuronium-induced muscle relaxation in morbidly obese patients: a meta-analysis of randomized controlled trials.2022Journal of International Medical Research
Sugammadex-induced anaphylactic reaction: A systematic review.2022Journal of Aneasthsiology Clinical Pharmacology
Sugammadex compared with neostigmine in reducing postoperative pulmonary complications in older patients: a meta-analysis2022British journal of anaesthesia
Sugammadex in Colorectal Surgery: A Systematic Review and Meta-analysis2022The Journal of surgical research
Sugammadex in systemic mastocytosis : Case report and a systematic review of literature2022Die Anaesthesiologie
Sugammadex in awakening from general anesthesia: systematic review and meta-analysis2022Revista da Associacao Medica Brasileira
Efficacy and safety of sugammadex for neuromuscular blockade reversal in pediatric patients: an updated meta-analysis of randomized controlled trials with trial sequential analysis2022BMC pediatrics
Efficacy and safety of sugammadex for the reversal of rocuronium-induced neuromuscular blockade in patients with end-stage renal disease: a systematic review and meta-analysis. 2021Medicina
The effect of dexamethasone on sugammadex reversal of rocuronium-induced neuromuscular blockade in surgical patients undergoing general anesthesia.2021Medicine
The effect of sugammadex on prothrombin and activated partial thromboplastin time. 2021Cureus
Postoperative pulmonary complications after sugammadex reversal of neuromuscular blockade: a systematic review and meta-analysis with trial sequential analysis2021Anesthesia, essays and researches
Influence of sugammadex versus neostigmine for neuromuscular block reversal on the incidence of postoperative pulmonary complications: a meta-analysis of randomized controlled trials2021Perioperative medicine
Epidemiology and outcomes of residual neuromuscular blockade: A systematic review of observational studies2020Journal of clinical anesthesia
Sugammadex for reversing neuromuscular blockages after lung surgery: A systematic review and meta-analysis2020Data in brief
Data and meta-analysis for choosing sugammadex or neostigmine for routine reversal of rocuronium block in adult patients2020Data in brief
Role of sugammadex in accelerating postoperative discharge: An updated meta-analysis2020Journal of clinical anesthesia
Incidence of residual neuromuscular blockade and use of neuromuscular blocking agents with or without antagonists: A systematic review and meta-analysis of randomized controlled trials2020Journal of clinical anesthesia
Use of sugammadex in patients with neuromuscular disorders: a systematic review of case reports2019BMC anesthesiology
The comparative efficacy and safety of sugammadex and neostigmine in reversing neuromuscular blockade in adults. A Cochrane systematic review with meta-analysis and trial sequential analysis.2018Anaesthesia
Postoperative complications with neuromuscular blocking drugs and/or reversal agents in obstructive sleep apnea patients: a systematic review2018BMC anesthesiology

Clinical Practice Guidelines

Document TitleYearSource
Peri-operative management of neuromuscular blockade: A guideline from the European Society of Anaesthesiology and Intensive Care2023European journal of anaesthesiology
Perioperative neuromuscular blockade. 2020 update of the SEDAR (Sociedad Española de Anestesiología y Reanimación) recommendations2023Revista espanola de anestesiologia y reanimacion
Clinical practice guideline for utilizing sugammadex in reversal of neuromuscular blocking agents.2019Doctor of Nursing Practice (DNP)/Master Scholarly Projects