Papathanas Michelle R, Killian Alley
Emory University Hospital, Atlanta, Georgia.
Adv Emerg Nurs J. 2017 Oct/Dec;39(4):248-257. doi: 10.1097/TME.0000000000000170.
Postoperative residual neuromuscular blockade is associated with an increased risk of respiratory insufficiency, aspiration, and potential pulmonary complications. The standard of care for reversal of residual block centers on anticholinesterases such as neostigmine. However, these medications provide inconsistent or inadequate effect while being associated with potentially severe adverse effects. Sugammadex, a modified γ-cyclodextrine compound, is a recently approved agent for the reversal of blockade with aminosterodial neuromuscular blockers. Randomized controlled trials, in addition to a meta-analysis and a systematic review, have published results indicating faster and more consistent reversal of blockade while leading to fewer adverse events.
术后残余神经肌肉阻滞与呼吸功能不全、误吸及潜在肺部并发症风险增加相关。残余阻滞逆转的护理标准以新斯的明等抗胆碱酯酶药物为核心。然而，这些药物效果不一致或不充分，同时还伴有潜在的严重不良反应。舒更葡糖钠是一种改良的γ-环糊精化合物，是最近获批用于逆转甾体类神经肌肉阻滞剂所致阻滞的药物。除一项荟萃分析和一项系统评价外，随机对照试验也已发表结果，表明其能更快、更一致地逆转阻滞，同时导致的不良事件更少。
