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Purpose We compared the reversal doses of sugammadex in surgical cases in which intraoperative neuromuscular monitor were used, to cases in which intraoperative neuromuscular monitoring was not used, retrospectively. Methods Data were collected by reviewing the electronic medical records of patients who received rocuronium and sugammadex during general anesthesia at Asahikawa Medical University Hospital between May 1, 2017 and April 30, 2018. The primary outcome was the reversal dose of sugammadex per patient actual body weight (mg/kg) between the group in which intraoperative neuromuscular monitoring was used (NM+ group) and the group in which intraoperative neuromuscular monitoring was not used (NM- group). Results A total of 3496 patients were evaluated, with 2544 patients (73%) included in NM+ group and 952 patients (27%) in NM- group. The reversal doses of sugammadex per actual body weight were significantly higher in NM- group compared to NM+ group. In the NM+ group, 521 patients (20%) received 2.5 mg/kg sugammadex. In contrast, 128 patients (13%) received 2.5 mg/kg sugammadex in NM- group. Conclusion This single-center retrospective study demonstrated that the use of intraoperative neuromuscular monitor reduced the reversal dose of sugammadex., Author(s): Hajime Iwasaki [sup.1], Atsushi Kurosawa [sup.1], Takafumi Iida [sup.1], Tomoki Sasakawa [sup.1], Hirotsugu Kanda [sup.1] Author Affiliations: (1) grid.252427.4, 0000 0000 8638 2724, Department of Anesthesiology and Critical Care [...]

We report the use of rocuronium to re-establish neuromuscular block after reversal with sugammadex. The aim of this study was to investigate the relationship between the dose of rocuronium needed to re-establish neuromuscular block and the time interval between sugammadex administration and re-administration of rocuronium. Patients who required re-establishment of neuromuscular block within 12 h after the reversal of rocuronium-induced neuromuscular block with sugammadex were included. After inducing general anesthesia and placing the neuromuscular monitor, the protocol to re-establish neuromuscular block was as follows. An initial rocuronium dose of 0.6 mg/kg was followed by additional 0.3 mg/kg doses every 2 min until train-of-four responses were abolished. A total of 11 patients were enrolled in this study. Intervals between sugammadex and second rocuronium were 12-465 min. Total dose of rocuronium needed to re-establish neuromuscular block was 0.6-1.2 mg/kg. 0.6 mg/kg rocuronium re-established neuromuscular block in all patients who received initial sugammadex more than 3 h previously. However, when the interval between sugammadex and second rocuronium was less than 2 h, more than 0.6 mg/kg rocuronium was necessary to re-establish neuromuscular block., Author(s): Hajime Iwasaki[sup.1] , Tomoki Sasakawa[sup.1] , Kenichi Takahoko[sup.1] , Shunichi Takagi[sup.2] , Hideki Nakatsuka[sup.3] , Takahiro Suzuki[sup.4] , Hiroshi Iwasaki[sup.1] Author Affiliations: (1) Department of Anesthesiology and Critical Care [...]