Service d'Anesthésie, Réanimation Chirurgicale, SAMU 94-SMUR, Groupe Hospitalier et Universitaire Albert-Chenevier-Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil Cedex, France.
Expert Opin Pharmacother. 2010 Nov;11(16):2759-71. doi: 10.1517/14656566.2010.528391.
Neuromuscular blocking agents are currently used during anesthesia but put patients at risk of postoperative paralysis. If the residual neuromuscular blockade is not reversed properly at the end of anesthesia, there is a risk of hypoxemia and pulmonary complication. Sugammadex is able to fully reverse different degrees of neuromuscular blockade induced by steroidal neuromuscular blocking agents.
This review provides a background to the use of neuromuscular blocking agents during anesthesia. It also describes the mechanism of reversal and the clinical efficacy of sugammadex, and discusses the future changes in clinical anesthesia induced by this new selective binding agent.
An understanding of the rationale and use of sugammadex as a reversal agent of different degrees of neuromuscular blockade and the use of the high-dose rocuronium-sugammadex combination as an alternative to succinylcholine for rapid sequence induction.
Sugammadex provides an original mechanism of reversing the effect of neuromuscular steroidal agent by direct inactivation in plasma. Although its effect is spectacular, it is questionable whether this drug will change current practice.
在麻醉期间，目前使用神经肌肉阻滞剂，但使患者有术后瘫痪的风险。如果在麻醉结束时不能正确地逆转残留的神经肌肉阻滞，就存在低氧血症和肺部并发症的风险。氨甲环酸能够完全逆转由甾体神经肌肉阻滞剂引起的不同程度的神经肌肉阻滞。
本综述提供了麻醉期间使用神经肌肉阻滞剂的背景。它还描述了氨甲环酸的逆转机制和临床疗效，并讨论了这种新的选择性结合剂对临床麻醉的未来变化。
了解氨甲环酸作为不同程度神经肌肉阻滞逆转剂的原理和用途，以及高剂量罗库溴铵-氨甲环酸组合作为琥珀胆碱快速序贯诱导替代物的用途。
氨甲环酸通过在血浆中直接失活提供了一种逆转甾体神经肌肉药物作用的原始机制。尽管其效果显著，但这种药物是否会改变当前的实践仍值得怀疑。
