Sugammadex

(Bridion®)

Bridion®

Drug updated on 12/11/2024

Dosage FormInjection (intravenous; 200 mg/2 mL, 500 mg/5 mL)
Drug ClassModified gamma cyclodextrin
Ongoing and
Completed Studies
ClinicalTrials.gov

Indication

  • Indicated for the reversal of neuromuscular blockade induced by rocuronium bromide and vecuronium bromide in adults and pediatric patients aged 2 years and older undergoing surgery.

Latest News

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Summary
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  • This summary is based on the review of 15 systematic review(s)/meta-analysis(es). [1-16]
  • Effectiveness in "can't intubate, can't ventilate" (CICV) Scenarios: In critical CICV cases, sugammadex successfully restored spontaneous ventilation in 75% (6/8) of cases, while 25% (2/8) experienced obstructed breathing patterns that required surgical airway intervention.
  • Efficacy in Morbidly Obese Patients: Sugammadex doses of 2 mg/kg and 4 mg/kg, based on 40% corrected body weight (CBW), effectively reversed moderate and deep neuromuscular blockade in morbidly obese patients, showing reliable and timely reversal.
  • Reversal in Pediatric Populations: Sugammadex at 2 mg/kg and 4 mg/kg significantly reduced the time to achieve Train-of-Four Ratio (TOFR) of 0.9 and extubation in pediatric patients compared to controls, indicating faster recovery from neuromuscular blockade.
  • Comparison to Neostigmine in Reducing Postoperative Complications: Sugammadex was superior to neostigmine in reducing postoperative pulmonary complications (PPCs) such as pneumonia and atelectasis, as well as decreasing the incidence of postoperative nausea and vomiting (PONV), particularly in settings involving volatile anesthetics.
  • Perioperative Anaphylaxis: Sugammadex was associated with a rare incidence of anaphylaxis, reported between 0.02% and 0.04% in observational studies.
  • Reduced Adverse Events Compared to Neostigmine: In pediatric and bariatric surgery patients, sugammadex demonstrated fewer adverse events and a lower risk of PONV and PPCs compared to neostigmine.
  • Sugammadex demonstrated reliable neuromuscular blockade (NMB) reversal in specific populations, including morbidly obese patients using a 40% corrected body weight dosing scalar, pediatric patients with faster reversal times and fewer adverse effects, bariatric surgery patients with faster and safer NMB reversal compared to neostigmine, and patients with neuromuscular disorders, where responses were generally successful but displayed some unpredictability in dosing effectiveness.

Product Monograph / Prescribing Information

Document TitleYearSource
Bridion (sugammadex) Prescribing Information.2022Merck & Co., Inc., Rahway, NJ

Systematic Reviews / Meta-Analyses

Document TitleYearSource
Use of Sugammadex in "Cannot Intubate, Cannot Ventilate" Scenarios: A Systematic Review of Case Reports2024Anesthesia and Analgesia
Optimal dosage of adamgammadex for reversal of rocuronium-induced neuromuscular block: a preliminary meta-analysis2024Systematic Reviews
Comparison of Different Weight Scalars to Dose Sugammadex for the Reversal of Neuromuscular Blockade in Morbidly Obese Patients: A Systematic Review2024Cureus
Efficacy and safety of sugammadex sodium in reversing rocuronium-induced neuromuscular blockade in children: An updated systematic review and meta-analysis2023Heliyon
Postoperative pulmonary complications after sugammadex reversal of neuromuscular blockade: a systematic review and meta-analysis with trial sequential analysis2023BMC Anesthesiology
Superiority of sugammadex in preventing postoperative pulmonary complications2023Chinese Medical Journal
The effect of sugammadex versus neostigmine on postoperative nausea and vomiting: a meta-analysis of randomized controlled trials with trial sequential analysis2023Minerva Anestesiologica
Sugammadex-induced anaphylactic reaction: A systematic review2022Journal of Anaesthesiology, Clinical Pharmacology
Appropriate dosing of sugammadex for reversal of rocuronium-/vecuronium-induced muscle relaxation in morbidly obese patients: a meta-analysis of randomized controlled trials2022The Journal of International Medical Research
Efficacy and safety of sugammadex for neuromuscular blockade reversal in pediatric patients: an updated meta-analysis of randomized controlled trials with trial sequential analysis2022BMC Pediatrics
Efficacy and Safety of Sugammadex versus Neostigmine in Reversing Neuromuscular Blockade in Morbidly Obese Adult Patients: A Systematic Review and Meta-Analysis2021Anesthesia, Essays and Researches
Systematic Review on Rocuronium Continuous Infusion for Deep Neuromuscular Blockade2021Current Reviews in Clinical and Experimental Pharmacology
Sugammadex versus neostigmine for routine reversal of rocuronium block in adult patients: A cost analysis2020Journal of Clinical Anesthesia
Forty years of neuromuscular monitoring and postoperative residual curarisation: a meta-analysis and evaluation of confidence in network meta-analysis2020British Journal of Anaesthesia
Use of sugammadex in patients with neuromuscular disorders: a systematic review of case reports2019BMC Anesthesiology
Rocuronium Continuous Infusion for Profound Neuromuscular Blockade: A Systematic Review and Meta-analysis2019Clinical Neuropharmacology

Clinical Practice Guidelines