Change in NMBA Practice Patterns Following Sugammadex Availability

Document Type

Conference Proceeding

Publication Date

10-20-2024

Abstract

Non-depolarizing neuromuscular blocking agents (NMBA) have been a popular choice of paralytic for intraoperative use and to facilitate endotracheal intubation for the last 50 years. Functioning by competitively antagonizing the action of acetylcholine at nicotinic receptors on skeletal muscle, their effects can be reversed with cholinesterase inhibitors such as neostigmine. This method of NMBA reversal has been largely replaced by Sugammadex at our institution since its introduction in 2019. Sugammadex functions by forming a complex with steroidal non-depolarizing NMBA, encapsulating them and removing them from the neuromuscular junction, thereby reversing their effects and restoring muscle function more rapidly than traditional reversal agents. Using Multicenter Perioperative Outcomes Group (MPOG) Data Direct access, we were able to extract data regarding sugammadex use and the use of cisatricurium and succinylcholine to track how the use of neuromuscular blocking agents has changed since the introduction of Sugammadex.MethodsUsing the Multicenter Perioperative Outcomes Group (MPOG) Data Direct software, we were able to enter each individual year, starting in 2020, to evaluate cisatricurium use after the introduction of Sugammadex in 2020. Cases were filtered to our institution and only included cases with valid anesthesia start/end time, general anesthesia duration >10 minutes, and valid ASA class, meeting the intraoperative research standard for the MPOG database. Additional filters were applied to extract values for cases using paralytic. By filtering cases usingparalytic for each individual year since 2020, we extrapolated the data for use of Sugammadex,succinylcholine, and for cisatracurium with below results

Comments

American Society of Anesthesiologists Annual Meeting, October 18-22, 2024, Philadelphia, PA

Link to Full Text

Share

COinS