A novel approach to reversal of neuromuscular blockade

Postoperative residual curarization is still a problem of the modern anesthesia. Neostigmine is not the safest drug that allows a safe decurarization, especially when neuromuscular transmission monitoring is not used. Sugammadex is a Á- cyclodextrin designed to encapsulate rocuronium bromide, providing a rapid reversal of neuromuscular blockade. It has not cardiovascular, respiratory and cholinergic effects. It has been used in renally impaired patients with no neu- romuscular blockade recurrence. Sugammadex reverses either a shallow or a deep neuromuscular block. Volatile agents such as sevoflurane seems not to influence the sugammadex ability to reverse the rocuronium neuromuscular block- ade. There is no difference in the sugammadex pharmacokinetic in children and adults. Sugammadex would be able to have a role in the future in reversing a non depolarizing steroidal neuromuscular block.