Département d'Anesthésie-Réanimation, Université de Lorraine, Nancy, France.
Curr Opin Anaesthesiol. 2012 Apr;25(2):217-20. doi: 10.1097/ACO.0b013e32834f012d.
Sugammadex belongs to a new class of drugs termed selective relaxant binding agents and is now available for clinical use in over 50 countries. Because of its innovative mechanism of action, reversal of rocuronium or vecuronium becomes independent of the degree of residual neuromuscular blockade. Deep or intense neuromuscular blockade now can rapidly and predictably be reversed. However, compared with the classical acetylcholine esterase inhibitor-based reversal treatment costs are significantly higher. On the basis of the current literature, the cost-effectiveness of sugammadex will be evaluated.
There is a paucity of evidence-based studies that investigate the pharmacoeconomic aspects of sugammadex reversal. However, several studies assessed the cost-effectiveness of routine reversal with sugammadex compared with cholinesterase inhibitors and one study from the UK analyzed the economic aspects of a rocuronium/sugammadex concept compared with succinylcholine in a 'cannot intubate-cannot ventilate' scenario. The concept of cost reduction by dose reduction of sugammadex is also addressed.
The reduction of recovery times with sugammadex will reduce the incidence of prolonged extubation and may increase patients' throughput. However, the achievable reduction of costs depends on the individual organizational factors, also.
Sugammadex 属于一种新型药物，称为选择性松弛剂结合剂，目前已在 50 多个国家投入临床使用。由于其创新的作用机制，罗库溴铵或维库溴铵的逆转不再依赖于残余神经肌肉阻滞的程度。现在可以快速且可预测地逆转深度或强烈的神经肌肉阻滞。然而，与经典的乙酰胆碱酯酶抑制剂为基础的逆转治疗相比，成本显著增加。基于目前的文献，将评估 sugammadex 的成本效益。
关于 sugammadex 逆转的药物经济学方面的研究证据很少。然而，有几项研究评估了 sugammadex 常规逆转与胆碱酯酶抑制剂相比的成本效益，一项来自英国的研究分析了罗库溴铵/ sugammadex 方案与琥珀胆碱在“无法插管-无法通气”情况下的经济学方面。还探讨了通过减少 sugammadex 的剂量来降低成本的概念。
使用 sugammadex 可缩短恢复时间，减少长时间拔管的发生率，并可能增加患者的吞吐量。然而，成本的降低幅度取决于个体组织因素。
