Key result
Sugammadex effectively reversed rocuronium-induced neuromuscular blockade in ESRD patients, though recovery to a TOF ratio ≥0.9 was prolonged compared to normal renal function (MD 1.14 min; 95% CI 0.29-2.00).
Why the study?
Most drugs display altered pharmacokinetics and reduced clearance in compromised kidney function, prompting an evaluation of the efficacy, pharmacokinetics, and safety of sugammadex in patients with ESRD undergoing general anesthesia.
Does sugammadex effectively and safely reverse rocuronium-induced neuromuscular blockade in patients with end-stage renal disease compared to patients with normal renal function?
Comparison
ESRD patients vs patients with normal renal function receiving sugammadex
Design
Systematic review and meta-analysis
Authors
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May support sugammadex consideration in ESRD with TOF monitoring; leaves open confirmation in randomized trials.
Meta-Analysis (n=655)
Does sugammadex effectively and safely reverse rocuronium-induced neuromuscular blockade in patients with end-stage renal disease compared to patients with normal renal function?
Mean Difference: 1.14 (95% CI 0.29–2)
Sugammadex effectively and safely reverses rocuronium-induced neuromuscular blockade in ESRD patients, though recovery time to a TOF ratio of 0.9 is slightly prolonged by about 1.14 minutes compared to patients with normal renal function.
Kim et al. (2021) conducted a meta-analysis in End-stage renal disease requiring general anesthesia (n=655). Sugammadex vs. Patients with normal renal function was evaluated on Time taken to reach a train-of-four ratio ≥0.9 (WMD 1.14 min, 95% CI 0.29 to 2.00). Sugammadex effectively reversed rocuronium-induced neuromuscular blockade in ESRD patients, though recovery to a TOF ratio ≥0.9 was prolonged compared to normal renal function (MD 1.14 min; 95% CI 0.29-2.00).
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