Rocuronium

Anesthesia

Adverse effect

Cochrane Library

Blood pressure

Neostigmine

Perioperative

Propofol

Internal medicine

Bradycardia

Heart rate

Sugammadex

Surgery

Randomized controlled trial

Neuromuscular Blockade

Medicine

British Journal of Anaesthesia

Sugammadex, a modified γ-cyclodextrin, has been increasingly used for antagonising rocuronium and vecuronium-induced neuromuscular block.1,2 The efficacy and safety of sugammadex has been well established.3 A recent Cochrane review noted that use of neostigmine is associated with a higher risk of adverse events compared with sugammadex (28% vs 16%, respectively).4 The risk of significant adverse outcomes such as residual paralysis, hypersensitivity and allergic reactions, postoperative nausea and vomiting, and bradycardia was also lower with sugammadex than neostigmine.

Severe bradycardia and asystole after sugammadex