“Ineffective” Sugammadex and “Over Effect” Sugammadex

Abstract

  “Ineffective” sugammadex may result in residual curarization, while “over effect” sugammadex may cause a problem with reintubation.
  Residual curarization will occur even if sugammadex is used. We should consider the possibility of residual curarization in cases of elderly patients, relatively small doses of sugammadex and anesthesia with sevoflurane. A good balance is necessary between sugammadex and rocuronium when reintubation is needed. The onset of efficacy of rocuronium may be late in the presense of shock or renal insufficiency.