دورية أكاديمية

Optimizing Reversal of Neuromuscular Block in Older Adults: Sugammadex or Neostigmine.

التفاصيل البيبلوغرافية
العنوان: Optimizing Reversal of Neuromuscular Block in Older Adults: Sugammadex or Neostigmine.
المؤلفون: Togioka BM; Department of Anesthesiology & Perioperative Medicine, Oregon Health & Science University, Portland, OR, USA. togioka@ohsu.edu.; Department of Obstetrics and Gynecology, Oregon Health & Science University, 3181 S.W. Sam Jackson Park Road, Mail Code: UHN-2, Portland, OR, 97239-3098, USA. togioka@ohsu.edu., Schenning KJ; Department of Anesthesiology & Perioperative Medicine, Oregon Health & Science University, Portland, OR, USA.
المصدر: Drugs & aging [Drugs Aging] 2022 Oct; Vol. 39 (10), pp. 749-761. Date of Electronic Publication: 2022 Aug 08.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Adis, Springer International Country of Publication: New Zealand NLM ID: 9102074 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1179-1969 (Electronic) Linking ISSN: 1170229X NLM ISO Abbreviation: Drugs Aging Subsets: MEDLINE
أسماء مطبوعة: Publication: Auckland : Adis, Springer International
Original Publication: Mairangi Bay, Auckland, N.Z. : Adis International, c1991-
مواضيع طبية MeSH: Neuromuscular Blockade*/adverse effects , Neuromuscular Nondepolarizing Agents*/therapeutic use , gamma-Cyclodextrins*/pharmacology , gamma-Cyclodextrins*/therapeutic use, Acetylcholine ; Acetylcholinesterase ; Aged ; Cholinesterase Inhibitors/pharmacology ; Cholinesterase Inhibitors/therapeutic use ; Humans ; Neostigmine/pharmacology ; Neostigmine/therapeutic use ; Postoperative Complications/etiology ; Rocuronium ; Sugammadex/pharmacology ; Vecuronium Bromide
مستخلص: Residual neuromuscular paralysis, the presence of clinically significant weakness after administration of pharmacologic neuromuscular blockade reversal, is associated with postoperative pulmonary complications and is more common in older patients. In contemporary anesthesia practice, reversal of neuromuscular blockade is accomplished with neostigmine or sugammadex. Neostigmine, an acetylcholinesterase inhibitor, increases the concentration of acetylcholine at the neuromuscular junction, providing competitive antagonism of neuromuscular blocking drug and facilitating muscle contraction. Sugammadex, a modified gamma-cyclodextrin, antagonizes neuromuscular blockade by encapsulating rocuronium and vecuronium in a one-to-one ratio for renal clearance, a pharmacokinetic property that led to the recommendation that sugammadex not be administered to those with end-stage renal disease. While data are limited, reports suggest sugammadex is efficacious and well tolerated in individuals with reduced renal function. Sugammadex provides a more rapid and complete reversal of neuromuscular blockade than neostigmine. There is also accumulating evidence that sugammadex may provide a protective effect against the development of postoperative pulmonary complications, nausea, and vomiting, and that it may have beneficial effects on the rate of bowel and bladder recovery after surgery. Accordingly, sugammadex administration is beneficial for most older patients undergoing surgery.
(© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)
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المشرفين على المادة: 0 (Cholinesterase Inhibitors)
0 (Neuromuscular Nondepolarizing Agents)
0 (gamma-Cyclodextrins)
361LPM2T56 (Sugammadex)
3982TWQ96G (Neostigmine)
7E4PHP5N1D (Vecuronium Bromide)
EC 3.1.1.7 (Acetylcholinesterase)
N9YNS0M02X (Acetylcholine)
WRE554RFEZ (Rocuronium)
تواريخ الأحداث: Date Created: 20220807 Date Completed: 20221013 Latest Revision: 20221227
رمز التحديث: 20231215
DOI: 10.1007/s40266-022-00969-4
PMID: 35934764
قاعدة البيانات: MEDLINE
الوصف
تدمد:1179-1969
DOI:10.1007/s40266-022-00969-4