Although anticholinesterase reversal agents have been used in combination with
anticholinergic drugs for over half a century, it has been suggested that they should be used
with caution in patients with underlying cardiovascular disease. As sugammadex has no
endogenous targets, it is unlikely to cause any adverse cardiovascular effects. This
selective relaxant binding agent is specifically designed to encapsulate rocuronium, which
can, therefore, promptly restore neuromuscular function regardless of any levels of NMB as
the dose is increased.
Some reports, however, suggest that sugammadex may have increased time to effect in some
patient populations like the elderly, patients in intensive care and renal failure patients.
A less dynamic circulation and increased transfer time to the effector site in these subjects
are likely explanations for this effect. The present trial was designed to assess the safety
and efficacy of sugammadex 2.0 mg kg-1 for the reversal of rocuronium-induced NMB in patients
with heart failure.