Effects of age on sugammadex reversal of neuromuscular blockade induced by rocuronium in Chinese children: a prospective pilot trial

Background: Sugammadex reverses neuromuscular blockade induced by steroidal relaxants. We compared the recovery for neuromuscular blockade reversal with sugammadex in children aged 1-12 years. Methods: From August 2019 to August 2020, patients who received 2.0 mg center dot kg(- 1) sugammadex for neuromuscular blockade reversal after surgery were recruited. The primary outcome was the time for the train-of-four ratio (TOFR) to recover to 0.9; secondary outcomes included the incidence of the TOFR < 0.9, extubation time, length of stay at the post-anesthesia care unit, and adverse events. Hemodynamic parameters before and 5 min after sugammadex administration and vital signs in the recovery room were also recorded. Results: Eighty-six children were recruited (1 to < 3 years, n = 23; 3 to < 5 years, n = 33; 5 to <= 12 years, n = 30). Intergroup differences in the recovery of the TOFR to 0.9 were not statistically significant (F = 0.691, p = 0.504). Recurrence of the TOFR < 0.9 was not observed in any group. Five minutes after sugammadex administration, the heart rates of patients aged 3 to < 5 and 5 to <= 12 years were significantly lower than those at baseline (p < 0.05). Extubation time was similar in patients aged 1 to <= 12 years. Length of stay and end-tidal capnography at the post-anesthesia care unit as well as adverse events did not differ significantly. Conclusion: A moderate (TOF count two) rocuronium-induced neuromuscular blockade can be effectively and similarly reversed with sugammadex 2 mg center dot kg(- 1) in Chinese children aged 1-12 years.

Automated summary

This study compared the efficacy of using Sugammadex for reversing neuromuscular blockade in children of different age groups, showing that in Chinese children aged 1-12 years, a moderate rocuronium-induced neuromuscular blockade can be effectively reversed with 2 mg/kg Sugammadex.