Worldwide experience with sugammadex sodium: implications for the United States.

Sugammadex sodium is a modified γ-cyclodextrin with a very high affinity for rocuronium and, to a lesser extent, vecuronium molecules. In vivo administration results in immediate encapsulation of rocuronium and vecuronium, resulting in termination of neuro- muscular blockade, usually within 3 minutes. This new neuromuscular blocking agent is specific for the aminosteroidal neuromuscular blocking agents rocuronium and vecuronium. Experience gained through worldwide clinical use of sugammadex offers US anesthesia providers the opportunity to better understand this new drug and its clinical applications. The seminal and current literature concerning clinical use of sugammadex is reviewed, and considerations for its incorporation into practice are provided.