Reversing rocuronium-induced neuromuscular block by sugammadex: New safety horizon for Indian population.

Background & aim: The study compared the efficacy of neostigmine and sugammadex in reversing rocuronium-induced neuromuscular blockade in patients undergoing surgery. The research aims to understand the drugs' benefits of safe reversal and impact in the diverse Indian population due to genetic, ethnic, lifestyle, and healthcare infrastructure differences.

Methods: The prospective randomized double-blind study was conducted in 40 patients of either sex, aged 18-60 years, belonging to the American Society of Anesthesiologists physical status I-II scheduled for surgery under general anaesthesia requiring tracheal intubation. Patients in group S were given Sugammadex 2mgkg-1 [SugmadexTM by Varenyam Healthcare India] and group N were given Neostigmine 0.05mgkg-1 with glycopyrollate 0.02mgkg-1 for the reversal of rocuronium. Time to reach TOF ratio of 0.9, extubation time, Aldrete score, adverse events, and hemodynamic changes were monitored.

Results: Both groups had comparable rocuronium doses and time to achieve 90% TOF ratio. However, sugammadex led to significantly faster extubation times (157.75 (97.33) [95% CI =61.0 - 414.50] sec) compared to neostigmine (341.50 (89.92) [95% CI =171.50 - 498.50] sec). Sugammadex was also associated with fewer adverse events and faster recovery based on the Aldrete score.

Conclusion: In conclusion, sugammadex proved superior to neostigmine, providing rapid reversal, shorter extubation times, and fewer side effects in rocuronium-induced neuromuscular blockade. In post operative period patient population with facio maxilla surgery will get increased safety. These findings have implications not only for India but also for the global medical community.