Bridion (sugammadex) / Merck (MSD) - LARVOL DELTA

Comparison of adductor pollicis and flexor hallucis brevis muscle electromyographic responses: a prospective cohort study. (PubMed, Can J Anaesth) - "While quantitative neuromuscular monitoring at the flexor hallucis brevis (foot) muscle showed some statistical differences in onset time and a recovery compared with monitoring at the adductor pollicis muscle (hand), these differences are of unclear clinical significance."

Journal • Anesthesia

Minimal Flow Anesthesia and Infection Risk (clinicaltrials.gov) - P=N/A | N=140 | Active, not recruiting | Sponsor: Ankara City Hospital Bilkent

New trial • Anesthesia • Infectious Disease

Sugammadex and Gastric Emptying: Individualized Patient Effects. (PubMed, Anesth Analg) - No abstract available

Journal

Molecular encapsulation of the aminosteroid phytotoxins solanidine and α-solanine by sugammadex: new insights into atomic-level interactions. (PubMed, Carbohydr Polym) - "The association constants of 2.3 × 106 M-1 and 6.0 × 106 M-1 for 1:1 SGM/SN and SGM/ASN complexes, respectively, indicate the additional stabilizing effect of the trisaccharide substituent. Single crystal X-ray analysis of the SGM/SN system highlighted the importance of the numerous interactions between the host and the steroidal backbone of the guest that prevail in the crystalline state."

Journal

Applying Best Clinical Practices to Patients at High Risk of Respiratory Complications (clinicaltrials.gov) - P4 | N=12248 | Completed | Sponsor: University of California, Los Angeles | Active, not recruiting ➔ Completed

Trial completion • Obstructive Sleep Apnea • Respiratory Diseases • Sleep Disorder

Use of Sugammadex for Reversal of Paralysis in Microlaryngoscopy (clinicaltrials.gov) - P4 | N=79 | Completed | Sponsor: West Virginia University | Recruiting ➔ Completed

Trial completion

Optimizing recovery in orthognathic surgery: the cohort study of impact of rocuronium-sugammadex on extubation and perioperative outcomes. (PubMed, Ann Med) - "Logistic regression identified sugammadex use as an independent protective factor against delayed extubation (OR = 0.26, 95% CI: 0.13-0.50, p < 0.001). The use of rocuronium with sugammadex in OGS is associated with enhanced postoperative recovery, including reduced extubation time, decreased intraoperative blood loss, and shorter hospital stay."

Journal • Retrospective data • Addiction (Opioid and Alcohol) • Anesthesia • Hypotension

Anesthetic Considerations and Intraoperative Management of a Patient with Brugada Syndrome (ASA 2025) - "Induction was achieved with midazolam, fentanyl, lidocaine, and etomidate; maintenance with remifentanil aimed to suppress sympathetic surges...Neuromuscular blockade was achieved with rocuronium and reversed with sugammadex...The case remained uneventful. This case highlights strategic perioperative planning in Brugada syndrome patients."

Clinical • Anesthesia • Bipolar Disorder • Cardiovascular • CNS Disorders • Genetic Disorders • Human Immunodeficiency Virus • Hypertension • Infectious Disease • Mood Disorders • Psychiatry • Pulmonary Embolism • Respiratory Diseases

Atypical Presentation of Anaphylaxis During Kidney Transplantation (ASA 2025) - "She was treated for anaphylaxis and local anesthetic toxicity with epinephrine and 20% lipid emulsion, respectively...One hour later, she developed angioedema and diphenhydramine was given. Tryptase level drawn at the time of presentation was elevated, consistent with anaphylaxis. Anaphylaxis to sugammadex is rare; a large retrospective study found an incidence of 0.039%, with all cases exhibiting onset of symptoms ≤4min and tachycardia."

Anesthesia • Cardiovascular • Hypotension • Transplantation

Recovery of the acute hypoxic ventilatory response after reversal of a minimal neuromuscular block. A randomized, controlled trial in healthy, non-obese volunteers. (PubMed, Anesthesiology) - "The AHVR after reversal of a minimal NMB with sugammadex did not significantly differ with spontaneous recovery of NMB. However, fewer patients had residual depression of AHVR when sugammadex was used. In all groups, a considerable proportion of patients had residual depression of the AHVR 40 minutes after recovery."

Journal • CNS Disorders • Depression • Obesity • Psychiatry

Sugammadex and Sudden Collapse: Cardiac Arrest Complicated by Takotsubo Cardiomyopathy (ASA 2025) - "Return of spontaneous circulation was achieved following a single round of cardiopulmonary resuscitation with epinephrine and atropine administration. This case highlights the importance of recognizing serious cardiovascular complications associated with sugammadex, particularly in elderly and high-risk surgical patients. Early recognition, prompt intervention, and preparedness are critical for optimizing patient outcomes."

Cardiomyopathy • Cardiovascular • Hypotension

Successful Treatment of Intraoperative Anaphylaxis with Sugammadex: A Case Report (ASA 2025) - "During the case, she was re-dosed with rocuronium and soon after, was noted to have severe hypotension. The surgical procedure was then aborted with a plan to extubate. The patient was fully reversed with Sugammadex, at which point her blood pressure stabilized and the epinephrine drip was no longer needed."

Case report • Clinical • Hypotension

Perioperative Challenges in a Teenager with Cerebral Palsy Undergoing Spinal Fusion (ASA 2025) - "Due to preoperative anxiety and vomiting, the patient underwent a rapid sequence induction with rocuronium followed by sugammadex reversal to enable neuromonitoring under TIVA. During the case, the patient suddenly became acutely hypotensive to the 30/10s, requiring multiple boluses of epinephrine to recover pressures...The case proceeded without further incident. The patient emerged from anesthesia uneventfully and was transferred to the ICU for further management."

Anesthesia • Cerebral Palsy • CNS Disorders • Mood Disorders • Psychiatry

Prolonged Neuromuscular Blockade During Electroconvulsive Therapy: A Case of Partial Pseudocholinesterase Deficiency (ASA 2025) - "For subsequent ECT sessions, her anesthesia was changed to rocuronium and sugammadex. This adjustment led to a smoother recovery and no recurrence of prolonged paralysis."

Clinical • Anesthesia • CNS Disorders • Depression • Psychiatry

Suspected Intraoperative Anaphylaxis to Sugammadex (Bridion®) (ASA 2025) - "Immediately after surgical completion, a diffuse urticarial rash, profound hypotension and signs of shock were observed requiring high doses of epinephrine. This case highlights the risk of repeat exposure to sugammadex. We expect to see an increasing incidence of peri-operative anaphylaxis associated with widespread use of sugammadex."

Dermatology • Hypotension • Immunology • Orthopedics • Urticaria

Re-curarization in the intensive care unit following surgery in a patient with advanced liver and kidney disease: The importance of neuromuscular monitoring (ASA 2025) - "Under bag-mask ventilation, EMG confirmed 0 twitches, and 230mg of sugammadex restored spontaneous breathing, avoiding re-intubation. This case describes re-curarization in the setting of sugammadex-rocuronium complex disassociation in patients with impaired renal function, highlighting the need for careful monitoring in these patients."

Clinical • Metastases • Surgery • Chronic Kidney Disease • Critical care • Nephrology • Renal Disease

Management of Subcutaneous Infiltration of Rocuronium in a Patient with Hepatic and Renal Impairment (ASA 2025) - "Rocuronium infiltration is a rare yet critical complication with unpredictable pharmacokinetics, potentially leading to prolonged neuromuscular blockade and respiratory compromise. This case reviews current evidence on recognizing and managing neuromuscular blocking agent infiltration, the role of sugammadex in reversal, and challenges in organ dysfunction. It highlights the need for standardized protocols to improve perioperative management."

Clinical • Renal Disease

Sugammadex-Induced Clenching During Neuromuscular Blockade Reversal (clinicaltrials.gov) - P=N/A | N=240 | Completed | Sponsor: Wonkwang University Hospital | Not yet recruiting ➔ Completed

Trial completion • Anesthesia

Anesthetic considerations for bifrontal meningioma craniotomy resection in a 19-week pregnant patient: a case report (ASA 2025) - "In this presentation we plan to discuss our anesthetic considerations, including pre-operative obstetric team involvement, intraoperative avoidance of mannitol for concerns of fetal oligohydramnios, alternative intracranial pressure management, the use of atropine and neostigmine for reversal vs sugammadex, and the use of remifentanil. To our knowledge, this is the first case report of the anesthetic considerations for a pregnant patient undergoing bifrontal meningioma craniotomy resection."

Case report • Clinical • Anesthesia • Brain Cancer • Meningioma • Obstetrics • Oncology • Solid Tumor

Anesthetic Considerations for Cesarean Section under General Anesthesia in Patient with Arthrogryposis Multiplex Congenita (ASA 2025) - "Rocuronium was utilized with Sugammadex readily available. Succinylcholine was avoided due to the patient's contractures. Uterine incision was made shortly after induction and the baby was delivered without complication."

Clinical • Anesthesia • Musculoskeletal Diseases

Transient neurological symptoms and abnormal magnetic resonance imaging (MRI) changes of the brain, following Sugammadex (SUG) reversal of neuromuscular blockade (NMB). (ASA 2025) - "A 65-year-old female received Rocuronium and SUG for anesthesia reversal, then developed gaze deviation, speech impairment, hemineglect, and weakness. While the mechanism is unclear, rat studies suggest possible neurotoxicity. Further investigation is needed."

MRI • Anesthesia • CNS Disorders • Epilepsy

A Case of Severe Intraoperative Anaphylaxis to Sugammadex Inspiring Development of an Institutional Anaphylaxis Emergency KitA Case of Severe Intraoperative Anaphylaxis to Sugammadex Inspiring Development of an Institutional Anaphylaxis Emergency Kit (ASA 2025) - "30s female with PMHx of asthma, anemia, endometriosis, HLH, and fibroids presented for elective hysterectomy. Patient stabilized with ICU team assistance using epinephrine, norepinephrine, vasopressin, and continuous nebs. We discuss intraoperative response to anaphylaxis and establishment of an anaphylaxis protocol and kit at our institution."

Clinical • Anemia • Anesthesia • Asthma • Cardiovascular • Endometriosis • Gynecology • Hematological Disorders • Hypotension • Immunology • Respiratory Diseases • Uterine Leiomyoma • Women's Health

Anesthetic Considerations in a Patient with Chronic Respiratory Failure and Situs Inversus Totalis with Dextrocardia (ASA 2025) - "Intra-operative management includes appropriate EKG leads placement to mirror the dextrocardia, minimizing long-acting opioids and respiratory depressants, as well as use of sugammadex to avoid increased secretions from cholinesterase inhibitors. Patient had close post-operative monitoring for symptoms of cor pulmonale."

Clinical • Anesthesia • Cardiovascular • Infectious Disease • Pneumonia • Pulmonary Arterial Hypertension • Pulmonary Disease • Respiratory Diseases

Examination of Emergence EEG Patterns Following Sugammadex Administration (ASA 2025) - "Abstract is embargoed at this time."

Anesthesia Management in a patient with Suspected Malignant Hyperthermia ,with Chronic Pain and Difficult Airway; Undergoing Temporomandibular Joint Surgery (ASA 2025) - "Asleep fibreoptic intubation was done after induction with ketamine, fentanyl, midazolam and rocuronium. Anesthesia was maintained with IV infusions of Dexmedetomidine, Ketamine, Remifentanil. Midazolam IV infusion was added later. Patient got extubated 45 minutes after reversal with Sugammadex & recovered completely."

Clinical • Surgery • Anesthesia • Genetic Disorders • Muscular Dystrophy • Myositis • Myotonic Dystrophy • Pain