Reversal of Neuromuscular Blockade: A Discrete Event Simulation Model of Clinical and Operating Room Efficiency Outcomes of Sugammadex Versus Neostigmine In Canada.

نویسندگان

  • R Insinga
  • C Joyal
  • J Schelfhout
  • K Yang
چکیده

• Neuromuscular blocking agents (NMBAs) are often administered during surgical procedures to provide muscle relaxation and prevent patient movement, which may increase the risk of surgical complications • When neuromuscular block no longer needs to be maintained, patients may either be allowed to spontaneously recover neuromuscular function or be administered a reversal agent for more rapid recovery • Sugammadex is a reversal agent licensed in the European Union, but not yet available in Canada, to reverse neuromuscular blockade induced by the NMBAs rocuronium and vecuronium • In clinical trials, sugammadex produced much more rapid and predictable reversal of neuromuscular block than comparator reversal agent neostigmine and, when quantitative neuromuscular monitoring was not required, a steep reduction in the incidence of residual neuromuscular blockade1-5 • In addition, sugammadex is effi cacious in rapidly reversing deep levels of neuromuscular blockade,6-8 whereas neostigmine is not8,9 • Prior models of sugammadex10,11 have explored potential impacts on operating room (OR) effi ciency and/or clinical outcomes modeling a single procedure – Or via a simple summation of identical procedures • To better understand sugammadex’s impact within the OR overall, a discrete event simulation (DES) model was developed to simulate an entire OR day over a 1-month period

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منابع مشابه

A discrete event simulation model of clinical and operating room efficiency outcomes of sugammadex versus neostigmine for neuromuscular block reversal in Canada

BACKGROUND The objective of this analysis is to explore potential impact on operating room (OR) efficiency and incidence of residual neuromuscular blockade (RNMB) with use of sugammadex (Bridion™, Merck & Co., Inc., Kenilworth, NJ USA) versus neostigmine for neuromuscular block reversal in Canada. METHODS A discrete event simulation (DES) model was developed to compare ORs using either neosti...

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OBJECTIVE The aim of the study is to evaluate the clinical and economic impact of introducing a rocuronium-neostigmine-sugammadex strategy into a cisatracurium-neostigmine regimen for neuromuscular block (NMB) management. METHODS We conducted a retrospective analysis of clinical outcomes and cost-effectiveness in five operating rooms at University Hospital of Padova. A clinical outcome evalua...

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Use of sugammadex in clinical practice

neostigmine), reverses neuromuscular blockade rapidly and effectively by encapsulating free circulating steroidal neuromuscular blocking agents (e.g., rocuronium) directly [1]. Moreover, sugammadex does not have muscarinic properties, whereas neostigmine has significant adverse muscarinic effects. Therefore, sugammadex is used in many countries as a new neuromuscular reversal agent to antagoniz...

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Effects of sugammadex on incidence of postoperative residual neuromuscular blockade: a randomized, controlled study.

BACKGROUND This study aimed to investigate whether reversal of rocuronium-induced neuromuscular blockade with sugammadex reduced the incidence of residual blockade and facilitated operating room discharge readiness. METHODS Adult patients undergoing abdominal surgery received rocuronium, followed by randomized allocation to sugammadex (2 or 4 mg kg(-1)) or usual care (neostigmine/glycopyrrola...

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عنوان ژورنال:
  • Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research

دوره 18 7  شماره 

صفحات  -

تاریخ انتشار 2015