Kaye Alan D, Villafarra Emily A, Everett Erin S, Ware Erin E, Mashaw Sydney A, Brouillette William D, Elder Camille G, Moss Taylor, Muiznieks Luke, Herron Edwin, Ahmadzadeh Shahab, Shekoohi Sahar
Departments of Anesthesiology and Pharmacology, Toxicology, and Neurosciences, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, 71103, USA.
School of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, 71103, USA.
Heliyon. 2025 Jan 8;11(2):e41757. doi: 10.1016/j.heliyon.2025.e41757. eCollection 2025 Jan 30.
The objective of this study was to analyze available evidence on efficacy and safety of sugammadex in reversing neuromuscular blockades in patients with Myasthenia Gravis (MG), thereby providing a comprehensive understanding of its potential benefits and risks in this specific patient population.
We performed a systematic search for studies from PubMed, Embase, Web of Science, and Google Scholar. Sources were screened using Rayyan, following predefined inclusion and exclusion criteria focusing on English articles published from 2010 to 2024 on MG patients under general anesthesia. Data on patient characteristics and outcomes were extracted, and quality was appraised using the JBI Critical Appraisal Checklist.
Out of 361 initial citations, 24 studies met inclusion criteria. Sugammadex demonstrated rapid and effective reversal of neuromuscular blockades, with ToF recovery times ranging from 79.7 s to 10 min, and short extubation times. The incidence of postoperative myasthenic crisis was low, and no mortalities were reported.
Sugammadex may serve as a reasonable option for the reversal of neuromuscular blockades in MG patients, indicating potential for rapid recovery and a relatively low incidence of serious complications. However, due to the limited number of studies and the nature of the evidence available, further large-scale and rigorous investigations are warranted to better establish its superiority over traditional reversal agents.
本研究的目的是分析关于舒更葡糖钠在重症肌无力（MG）患者中逆转神经肌肉阻滞的有效性和安全性的现有证据，从而全面了解其在这一特定患者群体中的潜在益处和风险。
我们对来自PubMed、Embase、科学网和谷歌学术的研究进行了系统检索。使用Rayyan按照预定义的纳入和排除标准对文献来源进行筛选，重点关注2010年至2024年发表的关于全身麻醉下MG患者的英文文章。提取患者特征和结局的数据，并使用JBI批判性评价清单对质量进行评估。
在361条初始引用文献中，24项研究符合纳入标准。舒更葡糖钠显示出能快速有效地逆转神经肌肉阻滞，强直后计数（ToF）恢复时间为79.7秒至10分钟，拔管时间短。术后肌无力危象的发生率较低，且无死亡报告。
舒更葡糖钠可能是MG患者逆转神经肌肉阻滞的合理选择，表明其具有快速恢复的潜力且严重并发症的发生率相对较低。然而，由于研究数量有限以及现有证据的性质，有必要进行进一步的大规模、严谨的研究，以更好地确定其相对于传统逆转剂的优势。
