Hallisey Stephen D, Prucnal Christiana K, Ilg Annette M, Seethala Raghu R, Jansson Paul S
Brigham and Women's Hospital, Department of Emergency Medicine, Division of Emergency Critical Care Medicine, Boston, Massachusetts.
Harvard Medical School, Department of Emergency Medicine, Boston, Massachusetts.
West J Emerg Med. 2025 Mar;26(2):347-352. doi: 10.5811/westjem.29328.
Non-depolarizing agents such as rocuronium and vecuronium are frequently used in the emergency department (ED) to facilitate intubation but may lead to delay in neurologic examination and intervention. Sugammadex is used for reversal of neuromuscular blockade by non-depolarizing agents but its role in the reversal of neuromuscular blockade for neurologic examination in the ED is poorly defined.
This was a multicenter cohort study using retrospective chart review. We reviewed all ED encounters from June 21, 2016-February 9, 2024 of the electronic health record of Mass General Brigham, a large multistate health system, and abstracted all ED administrations of sugammadex to facilitate neurologic examination. We calculated descriptive statistics and assessed outcomes.
In 3,080,338 ED visits during the study period, 48 patients received sugammadex to facilitate neurologic examination. Of those patients, 23 (47.9%) underwent a procedure within 24 hours. Three (6.3%) had bradycardia, and one (2.1%) had hypotension following sugammadex administration. A total of 23 patients (47.9%) ultimately died during their admission, and 24 (50%) died within 30 days.
Patients who received sugammadex in the ED to facilitate neurologic examination during the study period had rare associated adverse effects, high rates of procedures within 24 hours of administration, and significant in-hospital mortality. Prospective data is needed to assess the impact of sugammadex on decision-making.
罗库溴铵和维库溴铵等非去极化肌松药常用于急诊科以辅助插管，但可能导致神经学检查和干预延迟。舒更葡糖钠用于逆转非去极化肌松药引起的神经肌肉阻滞，但其在急诊科用于逆转神经肌肉阻滞以进行神经学检查方面的作用尚不明确。
这是一项使用回顾性病历审查的多中心队列研究。我们回顾了大型多州医疗系统马萨诸塞州综合医院布莱根分院2016年6月21日至2024年2月9日电子健康记录中的所有急诊科就诊情况，并提取了所有用于辅助神经学检查的舒更葡糖钠急诊科给药记录。我们计算了描述性统计数据并评估了结果。
在研究期间的3080338次急诊科就诊中，48例患者接受了舒更葡糖钠以辅助神经学检查。在这些患者中，23例（47.9%）在24小时内接受了一项操作。3例（6.3%）在使用舒更葡糖钠后出现心动过缓，1例（2.1%）出现低血压。共有23例患者（47.9%）在住院期间最终死亡，24例（50%）在30天内死亡。
在研究期间于急诊科接受舒更葡糖钠以辅助神经学检查的患者，相关不良反应罕见，给药后24小时内接受操作的比例高，且院内死亡率高。需要前瞻性数据来评估舒更葡糖钠对决策的影响。
