Sugammadex given for rocuronium-induced neuromuscular blockade in infants: a retrospectıve studyâ˜

•Multiple case reports describe the use of sugammadex in infants, but no large series exist.•Recovery of TOF >0.9 after 3 mg/kg sugammadex was 112.65 ± 35.60 seconds.•Sugammadex 3 mg/kg effectively antagonized rocuronium in infants without side effects.•Further clinic studies would enhance our knowledge about the use of sugammadex in infants.

Study ObjectiveTo evaluate the efficacy and safety of sugammadex in reversing profound neuromuscular block induced by rocuronium in infant patients.DesignRetrospective observational study.SettingUniversity teaching hospital.PatientsTwenty-six infants (2-12 months of age; 3-11 kg) with an American Society of Anesthesiologists classification I, II, or III who were scheduled to undergo neurosurgical procedures were included in the study.InterventionsAnesthesia was induced with 5 mg/kg thiopental, 1 μg/kg fentanyl and 0.6 mg/kg rocuronium. Sevoflurane was administered to all patients after intubation.MethodsThe neuromuscular block was monitored with acceleromyography using train-of-four (TOF) stimuli. Patients received additional doses of rocuronium to maintain a deep block during surgery. If profound neuromuscular block (TOF, 0) persisted at the end of the surgery, 3 mg /kg sugammadex was administered.MeasurementsThe demographic data, surgeries, and anesthetic agents were recorded. The time from sugammadex administration to recovery of neuromuscular function (TOF ratio, >0.9) and complications during and after extubation were also recorded.Main resultsTwenty-six infants who had a deep neuromuscular block (TOF, 0) at the end of surgery received 3 mg/kg sugammadex. The mean recovery time of the T4/T1 ratio of 0.9 was 112 seconds. No clinical evidence of recurarization or residual curarization was observed.ConclusionsThe efficacy and safety of sugammadex were confirmed in infant surgical patients for reversal of deep neuromuscular block induced by rocuronium.