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Sugammadex

Sugammadex is a modified gamma-cyclodextrin that acts as a selective relaxant binding agent, reversing the effects of neuromuscular blocking agents such as rocuronium and vecuronium.
It is used in anesthesia practice to rapidly reverse neuromuscular blockade and facilitate extubation.
Sugammadex binds to these agents, rendering them inactive and allowing for quick recovery of normal neuromuscular function.
It is an important tool in the managment of anesthesia and postoperative care, enabling safer and more efficient procedures.
Reserchers can leverge PubCompare.ai's AI-driven optimization to identify the most reproducible and accurtae Sugammadex research protocols, streamlining the research process.

Most cited protocols related to «Sugammadex»

Difficult Airway Society Guidelines Update

Cited 37 times

The Difficult Airway Society commissioned a working group to update the guidelines in April 2012. An initial literature search was conducted for the period January 2002 to June 2012 using databases (Medline, PubMed, Embase, and Ovid) and a search engine (Google Scholar). The websites of the American Society of Anesthesiologists (http://www.asahq.org), Australian and New Zealand College of Anaesthetists (http://www.anzca.edu.au), European Society of Anesthesiologists' (http://www.esahq.org/euroanaesthesia), Canadian Anesthesiologists' Society (http://www.cas.ca), and the Scandinavian Society of Anesthesiology and Intensive Care Medicine (http://ssai.info/guidelines/) were also searched for airway guidelines. English language articles and abstract publications were identified using keywords and filters. The search terms were as follows: ‘Aintree intubating catheter’, ‘Airtraq’, ‘airway device’, ‘airway emergency’, ‘airway management’, ‘Ambu aScope’, ‘backward upward rightward pressure’, ‘Bonfils’, ‘Bullard’, ‘bronchoscopy’, ‘BURP manoeuvre’, ‘can't intubate can't ventilate’, ‘can't intubate can't oxygenate’, ‘C-Mac’, ‘Combitube’, ‘cricoid pressure’, ‘cricothyroidotomy’, ‘cricothyrotomy’, ‘C trach’, ‘difficult airway’, ‘difficult intubation’, ‘difficult laryngoscopy’, ‘difficult mask ventilation’, ‘difficult ventilation’, ‘endotracheal intubation’, ‘esophageal intubation’, ‘Eschmann stylet’, ‘failed intubation’, ‘Fastrach’, ‘fiber-optic scope’, ‘fibreoptic intubation’, ‘fiberoptic scope’, ‘fibreoptic stylet’, ‘fibrescope’ ‘Frova catheter', ‘Glidescope’, ‘gum elastic bougie’, ‘hypoxia’, ‘i-gel’, ‘illuminating stylet’, ‘jet ventilation catheter’, ‘laryngeal mask’, ‘laryngeal mask airway Supreme’, ‘laryngoscopy’, ‘lighted stylet’, ‘light wand’, ‘LMA Supreme’, ‘Manujet’, ‘McCoy’, ‘McGrath’, ‘nasotracheal intubation’, ‘obesity’, ‘oesophageal detector device’, ‘oesophageal intubation’, ‘Pentax airway scope’, ‘Pentax AWS’, ‘ProSeal LMA′, ‘Quicktrach’, ‘ramping’, ‘rapid sequence induction’, ‘Ravussin cannula’, ‘Sanders injector’, ‘Shikani stylet’, ‘sugammadex’, ‘supraglottic airway’, ‘suxamethonium’, ‘tracheal introducer’, ‘tracheal intubation’, ‘Trachview’, ‘Tru view’, ‘tube introducer’, ‘Venner APA’, ‘videolaryngoscope’, and ‘videolaryngoscopy’.
The initial search retrieved 16 590 abstracts. The searches (using the same terms) were repeated every 6 months. In total, 23 039 abstracts were retrieved and assessed for relevance by the working group; 971 full-text articles were reviewed. Additional articles were retrieved by cross-referencing the data and hand-searching. Each of the relevant articles was reviewed by at least two members of the working group. In areas where the evidence was insufficient to recommend particular techniques, expert opinion was sought and reviewed.^{8 (link)} This was most notably the situation when reviewing rescue techniques for the ‘can't intubate can't oxygenate’ (CICO) situation.
Opinions of the DAS membership were sought throughout the process. Presentations were given at the 2013 and 2014 DAS Annual Scientific meetings, updates were posted on the DAS website, and members were invited to complete an online survey about which areas of the existing guidelines needed updating. Following the methodology used for the extubation guidelines,^{5 (link)} a draft version of the guidelines was circulated to selected members of DAS and acknowledged international experts for comment. All correspondence was reviewed by the working group.

Frerk C., Mitchell V.S., McNarry A.F., Mendonca C., Bhagrath R., Patel A., O'Sullivan E.P., Woodall N.M, & Ahmad I. (2015). Difficult Airway Society 2015 guidelines for management of unanticipated difficult intubation in adults. BJA: British Journal of Anaesthesia, 115(6), 827-848.

Publication 2015

Airway Management Anesthesiologist Anesthetist Bronchoscopy Cannula Catheters Dyspnea Emergencies Eructation Esophagus Europeans Frova Hypoxia Intensive Care Intubation Intubation, Intratracheal Laryngoscopy Light Medical Devices Obesity Pharmaceutical Preparations Pressure Rapid Sequence Induction Scandinavians Succinylcholine Sugammadex Trachea Tracheal Extubation

Fatigue in Sugammadex Survey Users

Cited 3 times

Subjects were categorized as “fatigued” or “not fatigued” according to whether they responded to the first unbranched sugammadex survey question (Table S2, Q-03) but did not complete the survey to the last question (Table S2, Q-10). This classification was used to perform logistic regression analysis against several independent variables, including provider role, frequency of app use, country income level, rating of app importance, and length of time in practice. Some of these were objectively gathered as metadata collected via the Survalytics package. Others were gathered from users as part of the basic demographic (Table S1).

, & O’Reilly-Shah V.N. (2017). Factors influencing healthcare provider respondent fatigue answering a globally administered in-app survey. PeerJ, 5, e3785.

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Publication 2017

Sugammadex

Anesthetic Management for Radical Cystectomy

Cited 2 times

Before the induction of anesthesia, all patients were monitored with electrocardiography, pulse oximetry, non-invasive blood pressure, end-tidal carbon dioxide concentration, and the bispectral index. General anesthesia was induced with 4–5 mg/kg thiopental sodium or 1.5–2 mg/kg propofol and 0.5–0.8 mg/kg rocuronium, and maintained with 1–4 vol% sevoflurane and 50% oxygen. Arterial catheterization was performed to continuously monitor the arterial blood pressure, and central venous catheterization was performed through the internal jugular vein. Tidal volume was adjusted to 8–10 mL per ideal body weight, and the respiratory rate was adjusted to maintain an end-tidal carbon dioxide concentration of 35–40 cmH₂O. Positive end-expiratory pressure and the recruitment maneuver were not applied in any patient. The concentration of sevoflurane was adjusted to maintain a bispectral index of 40–60. Mean arterial blood pressure was maintained above 65 mmHg, with fluid administration and the intermittent use of inotropic agents or vasopressors (e.g. ephedrine, phenylephrine, or norepinephrine). For fluid administration, both crystalloids such as lactated Ringer’s solution or plasma solution A (CJ Pharmaceutical, Seoul, Republic of Korea) and colloids such as 6% hydroxyethyl starch or 5% albumin were used. Transfusion of red blood cells was performed when hemoglobin concentration was < 8 g/dL. Neuromuscular blockade was reversed with a neostigmine-glycopyrrolate mixture or sugammadex at the discretion of the anesthesiologist. Intravenous patient-controlled analgesia with fentanyl was used for postoperative pain management.
Radical cystectomy and pelvic lymphadenectomy were performed according to the standard technique used at our center.19 (link),20 (link) Standard or extended pelvic lymph node dissection was performed at the discretion of urologic surgeons. Standard pelvic lymph node dissection included the hypogastric, distal common iliac, external iliac, obturator, and perivesical lymph nodes. Extended lymph node dissection included the lymph node to the extent of the inferior vena cava, distal aorta, and proximal common iliac artery. A subsequent urinary diversion with an ileal neobladder or ileal conduit was performed at the discretion of urologic surgeons. Five highly experienced urologic surgeons performed all the operations.

Yu J., Hong B., Park J.Y., Hwang J.H, & Kim Y.K. (2020). Impact of Prognostic Nutritional Index on Postoperative Pulmonary Complications in Radical Cystectomy: A Propensity Score-Matched Analysis. Annals of Surgical Oncology, 28(3), 1859-1869.

Publication 2020

Albumins Anesthesia Anesthesiologist Aorta Arteries Blood Pressure Carbon dioxide Catheterization Catheterization, Central Venous Colloids Electrocardiography Ephedrine Fentanyl General Anesthesia Glycopyrrolate Hemoglobin Hetastarch Ideal Body Weight Ileal Conduit Ileum Iliac Artery Ilium Jugular Vein Lactated Ringer's Solution Lymph Lymph Node Dissection Lymph Node Excision Neostigmine Neuromuscular Block Nodes, Lymph Norepinephrine Oximetry, Pulse Oxygen Pain, Postoperative Patient-Controlled Analgesia Patients Pelvis Pharmaceutical Preparations Phenylephrine Plasma Positive End-Expiratory Pressure Propofol Radical Cystectomy Red Blood Cell Transfusion Respiratory Rate Rocuronium Sevoflurane Solutions, Crystalloid Sugammadex Surgeons Thiopental Sodium Tidal Volume Urinary Diversion Vasoconstrictor Agents Vena Cavas, Inferior

Sugammadex versus Neostigmine Reversal

Cited 2 times

Continuous data were presented as medians and interquartile ranges due to skew; binary primary and secondary outcomes were summarized by frequencies and percentages for each matched group. Some continuous variables were transformed consistent with published clinical standards (body mass index) or clinically meaningful categories that incorporate realities of clinical documentation accuracy (estimated blood loss, time from last dose to reversal of extubation) as described in Supplemental Digital Content 2 and 3. Unadjusted differences between patients receiving sugammadex versus neostigmine were assessed using conditional logistic regression to account for the matching.
To assess the independent association between administration of sugammadex versus neostigmine reversal and the primary composite pulmonary complication, separate multivariable conditional logistic regression models were developed. Additional variables not used in matching were assessed for residual confounding using absolute standardized differences. Any covariate with a standardized difference > 0.10 was included in the multivariable analysis. In addition, surgical body region/invasiveness (16 distinct categorical variables) and NMBA (rocuronium alone, vecuronium alone, or both) were included. Adjusted odds ratios with 95% confidence intervals were reported for all models. Model discrimination and calibration were assessed using standard logistic regression methods, since current statistical software is unable to calculate diagnostic measures that account for the matched design.^{30 ,31 (link)} All statistical analyses were performed using SAS® version 9.4 (SAS Institute), and hypothesis testing was two-sided.
Using an approximated formula and assuming a conservative estimate for the sample proportions and 95% confidence, to achieve a margin of error of ±1%, we would need a study sample size of approximately 9,600. For the defined study period, we expected to observe greater than 30,000 patients receiving sugammadex.

Kheterpal S., Vaughn M.T., Dubovoy T.Z., Shah N.J., Bash L.D., Colquhoun D.A., Shanks A.M., Mathis M.R., Soto R.G., Bardia A., Bartels K., McCormick P.J., Schonberger R.B, & Saager L. (2020). Sugammadex versus Neostigmine for Reversal Of Neuromuscular Blockade and Postoperative Pulmonary Complications (STRONGER): A Multicenter Matched Cohort Analysis. Anesthesiology, 132(6), 1371-1381.

Publication 2020

Body Regions Diagnosis Discrimination, Psychology Hemorrhage Index, Body Mass Lung Neostigmine Operative Surgical Procedures Patients Rocuronium Sugammadex Tracheal Extubation Vecuronium

Mobile Anesthesia Calculator App Deployment

Cited 2 times

As described elsewhere (O’Reilly-Shah, Easton & Gillespie, in press (link)), the author has deployed a mobile anesthesia calculator app fitted with the Survalytics platform (O’Reilly-Shah & Mackey, 2016 (link)). A screenshot of the app interface is provided in Fig. S1. The calculator is designed to provide age and weight based clinical decision support for anesthetic management, including information about airway equipment, emergency management, drug dosing, and nerve-blocks. Survalytics enables cloud-based delivery of survey questions and storage of both survey responses and app “analytics” using an Amazon (Seattle, WA, USA) Web Services database. Here, analytics is used to mean collected and derived metadata including app use frequency, in-app activity, device location and language, and time of use. Two surveys were deployed: one to collect basic user demographic information, and another to characterize attitudes and adverse event rates related to the drug sugammadex. These surveys are available for review in the Supplementary Data in Tables S1 and S2. Survey questions appear immediately after launch of the app, with a “Not Now/Answer Later” button, so if the user is needing to reference the app for emergency purposes then they can immediately go to the calculator without being forced to the answer the survey. Although data collection is ongoing, the study period for this work is limited to data collected between December 2015 and February 2017. The sugammadex survey was deployed in March 2016. The results of the sugammadex survey itself are beyond the scope of the present analysis, although preliminary results have been presented at a meeting and in correspondence (O’Reilly-Shah, 2016 ; O’Reilly-Shah et al., in press (link)).
Raw data from the DynamoDB database were downloaded and processed using CRAN R (R Core Team, Vienna, Austria) v3.3 in the RStudio (RStudio Team, Boston, MA, USA) environment (South, 2011 ; Arel-Bundock, 2014 ; Ooms, 2014 ; R Core Team, 2015 ; RStudio-Team, 2015 ). User country was categorized using public World Bank classification of country income level (World Bank, 2016 ). In cases where users were active in more than one country, the country in which the most app uses were logged was taken as the primary country. Detailed information about the Survalytics package, the data collected for this study, and the approach to calculation of frequency of app use can be found in Appendix S1.
The study was reviewed and approved by the Emory University Institutional Review Board #IRB00082571. This review included a finding by the FDA that Anesthesiologist falls into the category of “enforcement discretion” as a medical device, meaning that, at present, the FDA does not intend to enforce requirements under the FD&C Act (FDA & U.S. Department of Health and Human Services, Food and Drug Administration, Center for Devices and Radiological Health, Center for Biologics Evaluation and Research, 2015 ).

, & O’Reilly-Shah V.N. (2017). Factors influencing healthcare provider respondent fatigue answering a globally administered in-app survey. PeerJ, 5, e3785.

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Publication 2017

Anesthesia Anesthesiologist Anesthetics Biological Factors Clinical Decision Support Emergencies Ethics Committees, Research Medical Devices Nerve Block Obstetric Delivery Pharmaceutical Preparations Sugammadex

Most recents protocols related to «Sugammadex»

Modified Montgomery Thyroplasty Procedure

Modified Montgomery thyroplasty was performed under general anesthesia with laryngeal mask insertion and muscle relaxation. The monitoring used was 5-lead ECG, non-invasive blood pressure, pulse oximetry (SpO₂), capnography (EtCO2), depth of anesthesia using Physiometrix SEDLine^®, and neuromuscular relaxation using TOF-WATCH SX^®.
Midazolam intravenous (0.03 mg kg⁻¹) was administered to reduce the patient’s anxiety as premedication. At the time of anesthetic induction, it was administered intravenously fentanyl (0.7 mcg kg⁻¹), propofol (2–2.5 mg kg⁻¹), and rocuronium (0.6 mg kg⁻¹). After 2 min in an optimal neuromuscular relaxation state (TOF ratio 0/0), Auragain laryngeal mask airway was introduced (see Figure 3A). A T-tube connector (Double Swivel Connector-Mallinchrodt™) was applied to the laryngeal mask (see Figure 3B) for subsequent insertion of the flexible fiberscope through it without compromising the anesthetized patient’s airway, ensuring adequate ventilation of the patient (Figure 3 and Figure 4). Repeated doses of rocuronium were administered (0.2 mg kg⁻¹) during the surgery when the TOF ratio was above 2/4 to ensure the relaxation and lateralization of the healthy vocal cord, keeping the glottic lumen open and thus allowing different medialization measurements of the paralyzed vocal cord without putting the airway at risk.
Anesthetic maintenance throughout the sedative was performed with continuous infusions of IV propofol (6 mg kg h⁻¹) and IV remifentanil (0.05–0.15 mcg kg min⁻¹) according to patient needs. For laryngeal mask ventilation, 6–7 mL kg⁻¹ tidal volume was delivered, with a respiratory rate adjusted to achieve an EtCO2 of 25–35 mmHg and a FiO² of 21–50% (reducing to 21% when the electric scalpel was used to minimize the risk of ignition). Likewise, the peak pressure in the airways was evaluated at the time of the tests with the meters mentioned above. This pressure must not exceed 40 cmH₂O, and it was necessary to check that the tidal volume was not reduced by more than 20% compared to the initial volume with the introduction of the definitive prosthesis meter. Therefore, monitoring the peak airway pressure at the time of prosthesis measurement influenced the decision on the definitive size of the final prosthesis.
After surgery, the patient was awakened: the intravenous infusions of propofol and remifentanil were stopped, and sugammadex (2–4 mg kg⁻¹, according to the relaxation grade) was administered IV to reverse the effects of muscle relaxation and speed recovery [23 (link)]. Prior to the removal of the laryngeal mask, the recovery of reflexes and response to basic verbal commands was expected, as well as spontaneous ventilation by the patient with TOF ratio > 0.9.
Other medications administered were: a prophylactic dose of antibiotic, such as 1 g/100 mg of amoxicillin-clavulanate (1 g/100 mg) or ciprofloxacine (200 mg) IV 30 min before the surgery, metilprednisolone (1 mg kg⁻¹) after the anesthesia induction, and paracetamol, ketoprofen and ondansetron iv 20 min before the surgery end.

Granell M., Martín A., Oishi N., Gimeno Coret M, & Zapater E. (2023). Anesthetic Technique and Functional Outcomes in Modified Montgomery Thyroplasty. Journal of Personalized Medicine, 13(2), 194.

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Publication 2023

Acetaminophen Amox clav Anesthesia Anesthetics Antibiotics Anxiety Blood Pressure Capnography Ciprofloxacin Condoms Electricity Fentanyl General Anesthesia Glottis Intravenous Infusion Ketoprofen Laryngeal Masks Limb Prosthesis Midazolam Ondansetron Operative Surgical Procedures Oximetry, Pulse Patients Pharmaceutical Preparations Premedication Pressure Propofol Reflex Relaxations, Muscle Remifentanil Respiratory Rate Rocuronium Saturation of Peripheral Oxygen Sedatives Sugammadex Thyroplasty Tidal Volume Vocal Cords

Preventing Remifentanil-Induced Hyperalgesia

The propofol infusion was stopped after skin closure, and the Ce of remifentanil was maintained as 1.0 ng.mL⁻¹ while patients were emerging from anesthesia to prevent remifentanil-induced hyperalgesia (RIH) in the S group [28 (link)]. In the M group, infusion of the RP mixture was stopped after skin closure. All patients received ketorolac (30 mg intravenously) prior to wound closure and local anesthetic wound infiltration with lidocaine for postoperative pain management. Reversal of neuromuscular function was achieved by administering sugammadex (2–4 mg.kg⁻¹) to prevent residual paralysis. When the patient regained consciousness with spontaneous and smooth respiration (TOF ratio ≥ 0.9), the endotracheal tube was removed, and the patient was sent to the post-anesthesia care unit (PACU) for further care. An independent investigator recorded the values of BIS and ANI, and the frequency of TCI device adjustments. Any bolus of remifentanil or propofol given intraoperatively was defined as a TCI pump adjustment. The hemodynamic parameters, including mean blood pressure (MBP) and HR, were recorded at baseline and at the following times: after intubation; at surgical incision; 30 min after skin incision; at the end of surgery; after extubation; and at emergence from anesthesia. Postoperative pain was assessed subjectively by the patients using a visual analogue scale (VAS) on arriving and leaving the PACU (the first postoperative hour) and on the first postoperative day [29 (link)]. When the patient’s VAS was > 4, fentanyl, 50 mcg, was given intravenously in the PACU. In this study, the RIH was defined as VAS > 4 after prescribing fentanyl ≥ 50 mcg within the first postoperative hour. The various time intervals (surgical time, anesthetic time, time for emergence); postoperative rescue analgesia; and adverse effects, such as postoperative nausea and vomiting (PONV) and RIH, were retrieved through anesthetic records and electronic medical records retrospectively. The duration of each phase was defined as follows: (1) surgical time: from skin incision to skin closure; (2) anesthetic time: from the beginning of induction to extubation; (3) time for emergence: from the end of surgery to eye-opening on verbal command; (4) overall patients’ satisfaction on postoperative day one was rated by a questionnaire using the following scale: 1, very unsatisfactory; 2, unsatisfactory; 3, neutral; 4, satisfactory; and 5, very satisfactory.

Lai H.C., Lai M.F., Huang Y.H., Yu J.C., Tseng W.C, & Wu Z.F. (2023). Comparison of Single Target-Controlled Infusion Pump-Delivered Mixed Propofol and Remifentanil with Two Target-Controlled Infusion Pumps-Delivered Propofol and Remifentanil in Patients Undergoing Breast Cancer Surgery—A Prospective Study. International Journal of Environmental Research and Public Health, 20(3), 2094.

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Publication 2023

Anesthesia Anesthetics Consciousness Fentanyl Hemodynamics Hyperalgesia Intubation Ketorolac Lidocaine Local Anesthesia Management, Pain Medical Devices Operative Surgical Procedures Pain, Postoperative Patients Propofol Remifentanil Respiration Skin Sugammadex Surgical Wound Tracheal Extubation Visual Analog Pain Scale Wounds

Sugammadex Use in Abdominal Surgery

Rocuronium, a neuromuscular blocking agent, was administered during major abdominal surgery. Following the operation, all patients were transferred to the PACU. Anesthetists could decide whether or not to use sugammadex according to their discretion. Time of administration of sugammadex depends on the anesthesia team’s clinical judgment [19 ]. Sugammadex was administered at 2 mg/kg, with a maximum of 200 mg per patient. The patients were extubated as soon as they awakened and were capable of following instructions. Tracheal extubation did not involve neuromuscular monitoring.

Tan J., He J., Wang L., Fang J., Li P., Song Z, & Bian Q. (2023). Analysis of the association of sugammadex with the length of hospital stay in patients undergoing abdominal surgery: a retrospective study. BMC Anesthesiology, 23, 32.

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Publication 2023

Abdomen Anesthesia Anesthetist Clinical Reasoning Neuromuscular Blocking Agents Patients Rocuronium Sugammadex Tracheal Extubation

Perioperative NMBA Use in Non-Cardiac Surgery

We conducted a single-center, retrospective observational study, including all adult patients admitted to Humanitas Research Hospital, a large university institute placed in Milan (Italy), between 1 January 2016 and 31 December 2019, for non-cardiac surgery under general anesthesia. The study received IRB approval (no. 757/20) from the Humanitas Research Hospital Independent Ethical Committee. Patient written informed consent was waived for this study by the IRB due to its retrospective design and anonymization of data.
The primary objective of the study was to describe real-world practice patterns of NMBAs and NMBA reversals in adult non-cardiac surgery patients. The secondary objective was to describe the factors associated with NMBA reversal and reversal agents.
We included all adult patients undergoing non-cardiac surgery with general anesthesia with endotracheal intubation, and treated with a NMBA (rocuronium, cisatracurium, atracurium, succinylcholine). Exclusion criteria were history of myasthenia gravis or home therapy with pyridostigmine, end-stage renal failure, use of two types of NMBA reversals (both sugammadex and neostigmine).
The intraoperative and perioperative practice followed standard anesthesiologic practice. The use of NMBA, neuromuscular monitoring, or NMBA reversal was not restricted during the study and was at the choice of the caring anesthesiologist.
Intraoperative and perioperative data were collected from the Electronic Health Record (EHR) system of our center, a high surgical-volume teaching hospital (about 800 beds hospital, 25,000 surgeries per year). Data were extracted from EHR repository and anonymized before inclusion in the study. Following DACQORD principles, intraoperative data were processed to verify for consistency and outliers, as well as for completeness and redundancy [9 (link)].
The study followed the STROBE guidelines [10 (link)]. Potential source of bias in the cohort study were identified in selection and reporting bias. Selection biases were considered to have minimal impact in this cohort study. This was due to the nature of EHR analysis data, the study selection criteria, and the large population extracted. Reporting bias may have influenced the quality and completeness of entered data. Some data may be under-reported; however, this type of error is unlikely to shift over time or have significant time trends and is limited by EHR completeness medi-co-legal criteria. We used imputation and sensitivity analyses to detect missing data bias.
Sample size estimation: Assuming a 0.30 mean base proportion across 4 years of rocuronium treatment, 8064 patients per year were needed to obtain a margin of error of 1% with 95% confidence interval.

Greco M., Caruso P.F., Angelotti G., Aceto R., Coppalini G., Martinetti N., Albini M., Bash L.D., Carvello M., Piccioni F., Monzani R., Montorsi M, & Cecconi M. (2023). REVersal of nEuromusculAr bLocking Agents in Patients Undergoing General Anaesthesia (REVEAL Study). Journal of Clinical Medicine, 12(2), 563.

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Publication 2023

Adult Anesthesia, Cardiac Procedures Anesthesiologist Atracurium cisatracurium General Anesthesia Hypersensitivity Intubation, Intratracheal Kidney Failure, Chronic Myasthenia Gravis Neostigmine Operative Surgical Procedures Patients Pyridostigmine Rocuronium Succinylcholine Sugammadex Surgical Procedure, Cardiac

Factors Associated with NBMA Reversal

Variables were described by frequencies (percentage) or mean (SD) and median (IQR), as appropriate. Univariate associations were tested by Chi-Square test, Chi-Square test for trend in proportions, and Mann-Whitney U test, as appropriate, considering a threshold of 0.05 statistical significance. We built a multivariable logistic regression model to describe factors associated with NBMA reversal, and secondary analysis to detect factors associated with the choice of sugammadex in the subpopulation of patients paralyzed with rocuronium. Before inclusion, missing data were analyzed and plotted for each variable to improve model performance. We used random-forest-based imputation of missing data before including variables in the logistic regression model, weighted by the level of missingness per feature (Figure S1). After imputation, the logistic regression model was built including clinically meaningful variables such as year, surgical specialty, and day-hospital surgery by default, and performing the selection of the other variables through a forward-backward stepwise regression approach using Aikake information criteria (AIC) for variable selection. Repeated k-fold cross validation was employed for internal model validation using 10 folds and 10 random repeats. Model discriminative performance was assessed through ROC analysis after cross-validation. Pooled calibration and precision-recall gain curve, which standardized precision against baseline chances expectations, were calculated. Sensitivity analysis on non-missing data only is reported in Figure S2.
All statistical analyses were performed using R software, version 4.1.1.

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Publication 2023

Discrimination, Psychology Hypersensitivity Mental Recall Patients Population Group Rocuronium Sugammadex Surgery, Day

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Sugammadex is a selective relaxant binding agent used in anesthesiology. It is designed to rapidly reverse the effects of certain neuromuscular blocking agents used during general anesthesia.

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More about "Sugammadex"

Sugammadex is a cutting-edge pharmaceutical agent that has revolutionized anesthesia practices.
This modified gamma-cyclodextrin compound acts as a selective relaxant binding agent, effectively reversing the effects of neuromuscular blocking agents such as rocuronium and vecuronium.
Researchers can leverage advanced tools like PubCompare.ai's AI-driven optimization to identify the most reproducible and accurate Sugammadex research protocols, streamlining the research process.
Sugammadex is an essential tool in the management of anesthesia and postoperative care, enabling safer and more efficient surgical procedures.
By binding to these neuromuscular blocking agents, Sugammadex renders them inactive, allowing for a quick recovery of normal neuromuscular function.
This rapid reversal of neuromuscular blockade is crucial for facilitating extubation and ensuring patient safety.
Researchers can explore the vast body of literature, pre-prints, and patents related to Sugammadex, utilizing AI-driven comparisons to identify the best protocols and products for their studies.
PubCompare.ai's platform empowers researchers to make informed decisions, optimizing their Sugammadex research workflow.
In addition to Sugammadex, researchers may also be interested in exploring related pharmacological agents such as Propofol, Ketamine, and Bovine serum albumin.
Statistical analysis tools like SAS version 9.4, Phoenix WinNonlin, and SPSS Statistics can provide valuable insights for data processing and interpretation.
Expanding the research horizons, researchers may also encounter topics like SMZ18 and Zearalenone, which are relevant in the broader context of pharmaceutical and environmental sciences.
The versatility of Sugammadex research allows for cross-disciplinary collaborations and a deeper understanding of the complex interactions within the field of anesthesiology and beyond.
By leveraging the power of AI-driven optimization and the wealth of information available, researchers can streamline their Sugammadex studies, leading to more reproducible and accurate findings that contribute to the advancement of anesthesia practices.
The journey of Sugammadex research is one of innovation, collaboration, and a relentless pursuit of improving patient outcomes.