# 手術結束時，麻醉醫師開立sugammadex 4 mg/kg IV。此藥物作用最正確的說明是什麼？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391879&lang=zh-tw  
> language: zh-TW  
> subject: Medical Emergencies  
> category: PA

## 題目

手術結束時，麻醉醫師開立sugammadex 4 mg/kg IV。此藥物作用最正確的說明是什麼？

## 選項

1. 選擇性結合並使rocuronium與vecuronium失活，以快速逆轉神經肌肉阻斷；比neostigmine + glycopyrrolate更快且更完整 **✔ 正確答案**
2. 逆轉succinylcholine造成的麻痺
3. 逆轉opioid過量
4. 治療惡性高熱症

**正確答案: 1**

## 解析

正確（2）：Sugammadex是修飾型cyclodextrin，可包覆rocuronium/vecuronium，使其離開神經肌肉接合處。比neostigmine更快、更完整，對深度阻斷也有效。不會逆轉benzylisoquinolinium類（cisatracurium）。（1）Succinylcholine由pseudocholinesterase自行代謝。（3）是naloxone。（4）是dantrolene。

## 深入解析

記憶提示 Sugammadex =「糖把Roc/Vec包起來」。舊式逆轉 = neostigmine + glycopyrrolate。Sugammadex會結合含雌激素避孕藥，需備用避孕1週。

## 臨床情境

情境 50歲女性，腹腔鏡手術結束時曾使用rocuronium；麻醉醫師在拔管前開立sugammadex 4 mg/kg IV。

## 重要概念

- **Sugammadex逆轉藥** — Cyclodextrin螯合劑；選擇性逆轉rocuronium與vecuronium。
- **Neostigmine逆轉** — Acetylcholinesterase抑制劑 + glycopyrrolate；非去極化NMBA的傳統逆轉方式。
- **Sugammadex與避孕藥交互作用** — 會結合progestin/estrogen；需備用避孕7天。

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