The Effect of Sugammadex on Prothrombin and Activated Partial Thromboplastin Time
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Key result
Sugammadex leads to a transient, dose-dependent increase in activated partial thromboplastin time and prothrombin time compared to standard care, with trivial clinical impact on bleeding.
Why the study?
Sugammadex is routinely used for neuromuscular blockade reversal, but several studies have indicated that it may prolong prothrombin time and activated partial thromboplastin time.
Does sugammadex prolong prothrombin time and activated partial thromboplastin time compared to standard care in patients undergoing neuromuscular blockade reversal?
Population
Nine in vivo studies
Comparison
Sugammadex vs standard care
Design
Review
Authors
Discussion
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Implication
Sugammadex remains appropriate for reversal without bleeding concern; confirms transient lab changes lack clinical impact in systematic evidence.
Study Design
Type
Systematic Review
Structured PICO
Does sugammadex prolong prothrombin time and activated partial thromboplastin time compared to standard care in patients undergoing neuromuscular blockade reversal?
P
Population
A systematic review of 9 in vivo clinical studies assessing the effect of sugammadex on prothrombin time and activated partial thromboplastin time.
I
Intervention
Sugammadex (doses ranging from 2 mg/kg to 16 mg/kg)
C
Comparator
Standard care (placebo, neostigmine, pyridostigmine, or no control)
O
Outcome
Prothrombin time (PT) and activated partial thromboplastin time (aPTT)surrogate
Sugammadex causes a transient, dose-dependent prolongation of PT and aPTT that does not appear to translate into a clinically significant increased risk of bleeding.
Limitations
- Great heterogeneity among the trials' findings preventing a meta-analysis.
- Great heterogeneity among trials preventing a meta-analysis
- Effect size measures in the included studies were not comparable
Cite This Study
Samara et al. (2021) conducted a systematic review in Neuromuscular blockade reversal. Sugammadex vs. Standard care (placebo, neostigmine, or pyridostigmine) was evaluated on Prothrombin time (PT) and activated partial thromboplastin time (aPTT). Sugammadex leads to a transient, dose-dependent increase in activated partial thromboplastin time and prothrombin time compared to standard care, with trivial clinical impact on bleeding.
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