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用于逆转神经肌肉阻滞的舒更葡糖:一项叙述性综述。

Sugammadex for Neuromuscular Blockade Reversal: A Narrative Review.

作者信息

Ravindranath Sapna, Backfish-White Kevin, Wolfe John, Ranganath Yatish S

机构信息

Department of Anesthesia, Indiana University School of Medicine, Indianapolis, IN 46202, USA.

出版信息

J Clin Med. 2025 Jun 11;14(12):4128. doi: 10.3390/jcm14124128.

Abstract

represents a significant advancement in neuromuscular blockade management, enabling rapid, predictable, and highly effective reversal of steroidal neuromuscular blockers such as rocuronium and vecuronium. This review critically examines recent advances in sugammadex research, particularly over the last decade, detailing its pharmacological profile, clinical efficacy, and safety compared to traditional reversal agents, like neostigmine. Its expanding clinical applications across operating rooms, critical care units, and emergency medicine are discussed, emphasizing dosing recommendations and clinical utility in special patient populations, including individuals with renal impairment, pediatric, obstetric, and obese patients. Economic considerations are explored, highlighting sugammadex's cost-effectiveness through reduced postoperative complications and enhanced operational efficiency, despite higher initial costs. Finally, the review outlines ongoing research directions, including emerging reversal agents, advanced neuromuscular monitoring technologies, and potential future clinical applications, underscoring sugammadex's evolving role in improving patient safety and anesthetic practice.

摘要

代表了神经肌肉阻滞管理方面的一项重大进展,能够快速、可预测且高效地逆转罗库溴铵和维库溴铵等甾体类神经肌肉阻滞剂的作用。本综述批判性地审视了舒更葡糖研究的最新进展,尤其是过去十年间的进展,详细阐述了其药理学特性、临床疗效以及与新斯的明等传统逆转剂相比的安全性。讨论了其在手术室、重症监护病房和急诊医学中的临床应用不断扩展的情况,强调了特殊患者群体(包括肾功能不全患者、儿科患者、产科患者和肥胖患者)的给药建议和临床效用。探讨了经济方面的考量,强调尽管初始成本较高,但舒更葡糖通过减少术后并发症和提高运营效率而具有成本效益。最后,该综述概述了正在进行的研究方向,包括新型逆转剂、先进的神经肌肉监测技术以及潜在的未来临床应用,强调了舒更葡糖在改善患者安全和麻醉实践中不断演变的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f09/12193823/460c457ae8a5/jcm-14-04128-g001.jpg

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