Drugs in anesthesia: Edited by Klaus T. OlkkolaSugammadex: a selective relaxant-binding agent providing rapid reversalRex, Christopher; Bergner, Urs A; Pühringer, Friedrich KAuthor Information Department for Anaesthesia and Intensive Care Medicine, Klinikum am Steinenberg, Academic Hospital of the University of Tübingen, Reutlingen, Germany Correspondence to Professor Dr Friedrich K. Pühringer, Department for Anaesthesia and Intensive Care Medicine, Klinikum am Steinenberg, Academic Hospital of the University of Tübingen, Steinenbergstrasse 31, D-72764 Reutlingen, Germany Tel: +49 7121 200 3429; fax: +49 7121 200 3576; e-mail: [email protected] Current Opinion in Anaesthesiology: August 2010 - Volume 23 - Issue 4 - p 461-465 doi: 10.1097/ACO.0b013e32833a5413 Buy Metrics Abstract Purpose of review Sugammadex is a new reversal agent with a unique mechanism of action in anaesthesia. Because of its rapid onset of action and its efficacy in determining neuromuscular blockade at any time, it opens up new perspectives in anaesthesia. Recent findings During the last few years, a lot of phase II and III studies have been published, investigating various groups of patients and clinical situations. Sugammadex has been shown to be a well tolerated drug, which appears to meet every challenge it is presented with in daily clinical practice. Summary Sugammadex binds amino-steroidal muscle relaxants by encapsulation. It enables rapid reversal of neuromuscular blockade at any time point and at any depth of block. Its effects are predictable and very reliable, in contrast to cholinesterase inhibitors. This opens up new perspectives in anaesthesia. Even an emergency reversal of high-dose rocuronium-induced neuromuscular blockade is possible with sugammadex and times to full recovery (TOF 0.9) are faster than after spontaneous recovery from suxamethonium. © 2010 Lippincott Williams & Wilkins, Inc.