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Competitive neuromuscular blocking agents, principally rocuronium, can rapidly achieve paralysis for intubation, but their effects last for well over 30 minutes and can’t be reversed until after significant spontaneous recovery has occurred. A new class of drugs, selective relaxant binding agents, specifically reverses the effects of aminosteroid neuromuscular blocking agents (e.g., rocuronium, vecuronium, and pancuronium). Sugammadex, which specifically binds rocuronium, is the first of this class to come to clinical trials.
In a phase II study supported by the manufacturer of sugammadex, 50 ASA class I–III patients undergoing general anesthesia for elective surgery were randomized to receive one of two doses of rocuronium (0.6 or 1.2 mg/kg…