Neuromuscular Blockade Refresher

This review article from the World Federation of Societies of Anaesthesiologists is a great clinical review on Sugammadex and a good way to dust the cobwebs off your thinking about neuromuscular blockade and physiology.

Sugammadex Pic

From an ED point of view the use of Sugammadex is in the setting of modified RSI following the use of high-dose rocuronium to achieve similar intubating conditions as with regular RSI using suxamethonium.  If this type of modified RSI leads to a CICO scenario then the use of Sugammadex may be a salvage option.  It is an important drug of which to be aware – make sure you know its mechanism of action, indications in ED, dose, and potential side effects.

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