Sugammadex (Bridion(R) )

[tristarell]

Hi everyone,
I was wondering if anyone has had any experience with Sugammadex at their hospital(s)?
I would like to know if anyone has developed a policy or protocol for its correct use? i.e. so the anaesthetists can't reverse NM verc or roc blockage and finish a case more quickly!
Any help or info on this would be gratefully received!
Cheers
tristar ell

[johnep]

I used to sell 'Alloferin' over 40 years ago. Thanks for raising subject of neuromuscular block and reversal.
johnep

[tristarell]

Schering-Plough are marketing this product in the UK. The marketting authorisation was granted back in July 08.

Bridion 100 mg/ml solution for injection - Summary of Product Characteristics (SPC) - electronic Medicines Compendium (eMC)

Hopefully some of the bigger centres will have heard of it?

[Jeff]

so the anaesthetists can't reverse NM verc or roc blockage and finish a case more quickly!

From my position of total ignorance why is it a bad thing for an anaesthetist to finish a case more quickly?

[tristarell]

From my position of total ignorance why is it a bad thing for an anaesthetist to finish a case more quickly?

There is a significant increased cost associated with the use of sugammadex, compared to the slower acting alternative, neostigmine (with atropine or glycopyrrolate).

Additionally, if an anaesthetist used sugammadex in this way, and then left the hospital as soon the patient had begun recovery, the patient is exposed to risk in situations if NMB were to recur (highly unlikely but possible).

This is of concern in the private hospital setting; as we cannot always guarantee there would be another anaesthetist to step in.

[johnep]

Thanks for jogging my memory. I used to sell Prostigmin for reversal and, surprisngly, intractable constipation.
Mestinon was for Myasthenia Gravis and Tensilon was used for diagnosis. Lifting of drooping eyelids.
Mestinon also used by military as nerve gas antidote. Got me a nice trip to Phillidelphia (correct spelling?).
johnep