The available studies suggest dosages of sugammadex that will most likely change as new trials emerge that take into consideration the plasma concentration of the neuromuscular relaxant, its correlation with the depth of the relaxation measured by TOF and the determination of the dose of the reversal agent based on such concentration. 1. Belizán JM, Althabe F, Barros FC, et al. Rates and implications of caesarean sections in Latin America: ecological study. BMJ. 1999;319:1397-400. 2. King H, Ashley S, Brathwaite D, et al. Adequacy of general anesthesia for cesarean section. Anesth Analg. 1993;77:84-8. 3. Viby-Mogensen J, Engbaek J, Eriksson LI, et al. Good clinical research practice GCRP in pharmacodynamic studies of neuro-muscular blocking agents. Acta Anaesthesiol Scand. 1996;40:59-74. 4. Adnet F, Borron SW, Racine SX, et al. The intubation difficulty scale IDS. Proposal and evaluation of a new score characterizing the complexity of endotracheal intubation. Anesthesiology. 1997;87:1290-7. 5. Somers R, Jacquemyn Y, Sermeus L, et al. Corrected scoliosis, cholinesterase deficiency, and cesarean section: a case report. Case Report Med. 2009;2009:957479. 6. Guay J, Grenier Y, Varin F. Clinical pharmacokinetics of neuromuscular relaxants in pregnancy. Clin Pharmacokinet. 1998;34:483. 7. Andrews WW, Ramin SM, Maberry MC, et al. Effect of type of anesthesia on blood loss at elective repeat cesarean section. Am J Perinatol. 1992;9:197-200. 8. España. Ministerio de Sanidad y Política Social. Estudio IBEAS: Prevalencia de Efectos Adversos en Hospitales de Latinoamérica. Madrid: Ministerio de Sanidad y Política Social; 2009. 9. Abu-Halaweh SA, Massad IM, Abu-Ali HM, et al. Rapid sequence induction and intubation with 1 mg/kg rocuronium bromide in cesarean section, comparison with suxamethonium. Saudi Med J. 2007;28:1393-6. 10. Murphy GS. Residual neuromuscular blockade: incidence, assessment, and relevance in the postoperative period. Minerva Anestesiol. 2006;72:97-109. 11. Plaud B, Debaene B, Donati F, et al. Residual paralysis after emergence from anesthesia. Anesthesiology. 2010;112:1013-22. 13. Cammu G, De Witte J, De Veylder J, et al. Postoperative residual paralysis in outpatients versus inpatients. Anesth Analg.2006;102:426-9. 14. Debaene B, Plaud B, Dilly MP, et al. Residual paralysis in the PACU after a single intubating dose of nondepolarizing muscle relaxant with an intermediate duration of action. Anesthesiology. 2003;98:1042-8. 15. Davis ME, Brewster ME. Cyclodextrin-based pharmaceutics: past, present and future. Nat Rev Drug Discov. 2004;3:1023-35. 16. Álvarez Gómez JA, et al. Reversal of vecuronium-induced moderate neuromuscular blockade is significantly faster with sugammadex compared with neostigmine. Results from the AURORA trial. Poster presented at the European Society of Anaesthesiology, 9-12 June 2007, Munich, Germany. 17.Schaller SJ, Fink H, Ulm K, et al. Sugammadex and neostigmine dose-finding study for reversal of shallow residual neuromuscular block. Anesthesiology. 2010;113:1054-60.
Los estudios disponibles sugieren dosis de sugammadex las cuales, muy probablemente, cambiarán con el advenimiento de nuevos trabajos que considerarán la concentración plasmática del relajante neuromuscular, su correlación con la profundidad de relajación medida en el TOF y la determinación de la dosis del reversor según dicha concentración.