At the end of surgery, the anesthesiologist orders sugammade… | MyMerci
Medical EmergenciesPA
Question
At the end of surgery, the anesthesiologist orders sugammadex 4 mg/kg IV. Which is the most accurate explanation of this medication's role?
1Selectively binds and inactivates rocuronium and vecuronium for rapid reversal of neuromuscular blockade — faster and more complete than neostigmine + glycopyrrolate✓ Correct answer
2Reverses succinylcholine paralysis
3Reverses opioid overdose
4Treats malignant hyperthermia
Explanation
Correct (2): Sugammadex is a modified cyclodextrin that encapsulates rocuronium/vecuronium, removing them from neuromuscular junctions. Faster, more complete than neostigmine. Effective even for deep block. Does NOT reverse benzylisoquinoliniums (cisatracurium). (1) Succinylcholine self-metabolized by pseudocholinesterase. (3) Naloxone. (4) Dantrolene.
In-depth explanation
Memory Tip Sugammadex = "Sugar wraps the Roc/Vec." Old reversal = neostigmine + glycopyrrolate. Sugammadex binds estrogen-based OCs — backup contraception for 1 week.
Clinical scenario
Scenario 50-year-old female at end of laparoscopic surgery received rocuronium; anesthesiologist orders sugammadex 4 mg/kg IV before extubation.
Key concepts
Sugammadex — Cyclodextrin chelator; selectively reverses rocuronium and vecuronium.