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Sugammadex administration in patients with end-stage renal disease: a narrative review with recommendations

Oh SK, Lim BG

Due to unknown safety concerns, sugammadex should not be administered to patients withend-stage renal disease (ESRD). However, because the supply of benzylisoquinolinium-typeneuromuscular blocking agents (NMBAs) has been discontinued, rocuronium is...
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Does the Use of Rocuronium-Sugammadex Instead of Succinylcholine in Electroconvulsive Therapy Affect Seizure Duration?

Oflezer C, Atay , Kaşdoğan ZE, Özakay G, İpekçioğlu D, Bahadır H

Objective We compared retrospectively the seizure variables of electroconvulsive therapy (ECT) patients after administration of rocuronium-sugammadex or succinylcholine as a muscle relaxant with propofol anesthesia. Methods The sample comprised 134 ECT...
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Prolongation of the effect of a single dose of rocuronium in a patient with postpolio syndrome under desflurane anesthesia: a case report

Kimura Y, Nitta Y, Shibuya M, Fujisawa T

Postpolio syndrome (PPS) is widely known to manifest as muscle weakness in patients affected by poliomyelitis in early childhood. This is caused by the long-term overwork of motor nerves regenerated...
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A Cohen syndrome patient whose muscle-relaxant effect may have been prolonged during general anesthesia: a case report

Ishikawa E, Shibuya M, Kimura Y, Kamekura N, Fujisawa T

Cohen syndrome is a rare genetic disorder associated with mutations in the VPS13B gene. Individuals with this disorder present with diverse clinical manifestations, including muscle hypotonia, intellectual disabilities, and typical...
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Effects of hydrocortisone-presensitized sugammadex on recovery from neuromuscular blockade induced by rocuronium: a rodent in vivo study

Choi HR, Yang HS, Choi JM, Park C, In J, Kim YB

Background: Sugammadex is a specific antagonist of aminosteroidal neuromuscular blocking agents with 1:1 binding to guest molecules. Sugammadex can also bind to other drugs having a steroid component in its...
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The use of sugammadex in an infant with prolonged neuromuscular blockade - A case report -

Kim H, Cho J, Lee S, Lim Y, Yoo B

Background: Residual neuromuscular blockade (RNMB) is a frequent event after general anesthesia, which can lead to serious complications, such as upper airway obstruction. Sugammadex is useful in reversing RNMB. However,...
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Treatment of rocuronium-induced anaphylaxis using sugammadex - A case report -

Kim SM, Oh Sh, Ryu SA

Background: Perioperative anaphylaxis is a life-threatening clinical condition characterized by severe respiratory and cardiovascular manifestations. Neuromuscular blocking agents are the most common cause of anaphylaxis during anesthesia. Case: We report...
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Rocuronium Induced Masseter Muscle Rigidity during Intubation in Patients with Dental Surgery

Jung MS, Lee H, Kim H, Park SE, Oh J

Masseter muscle rigidity (MMR), known as the ‘jaw of steel’, sometimes makes laryngoscope unusable due to the stiffness of the jaw. MMR during general anesthesia was previously considered as an...
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Anaphylaxis induced by sugammadex and sugammadex-rocuronium complex -a case report-

Choi SC, Han S, Kwak J, Lee JY

Background: In sugammadex-induced anaphylaxis, sugammadex and/or sugammadex-rocuronium complex have possible allergenic epitope. Case: We report a case of sugammadex-induced anaphylaxis during general anesthesia in a 60-year-old male undergoing...
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Advantages and pitfalls of clinical application of sugammadex

Lee HY, Jung KT

Sugammadex, a modified γ-cyclodextrin, is one of the drugs focused on in the anesthetic field because it provides rapid and complete reversal from neuromuscular blockade (NMB) by encapsulating rocuronium. Its...
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Airway anesthesia with lidocaine for general anesthesia without using neuromuscular blocking agents in a patient with a history of anaphylaxis to rocuronium: a case report

Ji SM, Song J, Choi G

We experienced a case of induction of general anesthesia without using neuromuscular blocking agents (NMBAs) in a 40-year-old woman with a history of anaphylaxis immediately after the administration of anesthetics...
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Effects of different sugammadex doses on the train of four ratio recovery progression during rocuronium induced neuromuscular blockade in the rat phrenic nerve hemidiaphragm

Kim YB, Choi JM, Chang YJ, Choi HR, In J, Yang HS

Background: In this study, we used an ex-vivo model to investigate the recovery pattern of both the train-of-four (TOF) ratio and first twitch tension of TOF (T1), and determined their...
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Anaphylactic shock after sugammadex administration, induced by formation of a sugammadex-rocuronium complex: a case report

Kim GH, Choi WS, Kim JE, Yun MJ, Koo MS, Kwon M, Seo H

BACKGROUND: Sugammadex is a reversal agent for non-depolarizing neuromuscular blockers and widely used worldwide on account of its rapid and effective reversal from neuromuscular blockade, despite its advantages, multiple cases...
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Effects of dexamethasone and hydrocortisone on rocuronium-induced neuromuscular blockade and reversal by sugammadex in phrenic nerve-hemidiaphragm rat model

Choi H, Park SY, Kim YB, In J, Yang HS, Lee JS, Kim S, Park S

BACKGROUND: The facilitator effects of steroids on neuromuscular transmission may cause resistance to neuromuscular blocking agents. Additionally, steroids may hinder sugammadex reversal of neuromuscular blockade, but these findings remain controversial....
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Comparison of sugammadex and pyridostigmine bromide for reversal of rocuronium-induced neuromuscular blockade in short-term pediatric surgery: a prospective randomized study

An J, Kim E, Lee J, Kim H, Son J, Huh J, Woo K

BACKGROUND: Sugammadex reverses rocuronium-induced neuromuscular blockade quickly and effectively. Herein, we compared the efficacy of sugammadex and pyridostigmine in the reversal of rocuronium-induced light block or minimal block in pediatric...
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Severe Anaphylaxis without Key Signs Such as Urticaria and Bronchospasm Suspected to Be Induced by Rocuronium

Kim AJ, Chun HR

Perioperative hypersensitivity reaction have been reported to have a variable degree of the incidence from differ countries and to be 1/353–18,600 approximately and its mortality has been reported to be...
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Perioperative Anesthetic Management of a Patient with Dermatomyositis

Koo BS

Dermatomyositis is a relatively rare myopathy which is characterized by muscle weakness and chronic inflammatory changes in muscle and skin. Dermatomyositis typically presents with subacute, progressive proximal muscle weakness, a...
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Effects of adenosine receptor agonist on the rocuronium-induced neuromuscular block and sugammadex-induced recovery

Kim YB, Lee S, Choi HR, In J, Chang YJ, Kim HJ, Ro YJ, Yang HS

BACKGROUND: Several types of receptors are found at neuromuscular presynaptic membranes. Presynaptic inhibitory A1 and facilitatory A2A receptors mediate different modulatory functions on acetylcholine release. This study investigated whether adenosine...
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The effect of magnesium sulfate concentration on the effective concentration of rocuronium, and sugammadex-mediated reversal, in isolated left phrenic nerve hemi-diaphragm preparations from the rat

Cho CK, Sung TY, Choi SJ, Choi HR, Kim YB, Lee JU, Yang HS

BACKGROUND: Perioperative magnesium sulfate (MgSO4) is used for analgesic, anti-arrhythmic, and obstetric purposes. The effects of MgSO4 on the neuromuscular blockade (NMB) induced by rocuronium, and the sugammadex reversal thereof,...
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Initial experience with the unrestricted introduction of sugammadex at a large academic medical center: a retrospective observational study examining postoperative mechanical ventilation and efficiency outcomes

O'Reilly-Shah VN, Lynde GC, Mitchell M, Maffeo CL, Jabaley CS, Wolf FA

BACKGROUND: Sugammadex rapidly reverses deep neuromuscular blockade, but owing to cost, questions remain about its optimal utilization. After the unrestricted introduction of sugammadex at Emory University Hospital, we hypothesized that...
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