RESUMEN
Objective: to determine the ED90 (minimum effective dose in 90% of patients) of sugammadex for the reversal of rocuronium-induced moderate neuromuscular blockade (NMB) in patients with grade III obesity undergoing bariatric surgery. Methods: we conducted a prospective study with the biased coin up-and-down sequential design. We chosen the following doses: 2.0mg/Kg, 2.2mg/Kg, 2.4mg/Kg, 2.6mg/Kg, 2.8mg/Kg. The complete reversal of rocuronium-induced NMB considered a T4/T1 ratio ≥0.9 as measured by TOF. After induction of general anesthesia and calibration of the peripheral nerve stimulator and accelerometer, we injected rocuronium 0.6mg/kg. We administered propofol and remifentanil by continuous infusion, and intermittent boluses of rocuronium throughout the procedure. Results: we evaluated 31 patients, of whom 26 had displayed successful reversal of the NMB with sugammadex, and failure in five. The mean time to complete moderate NMB reversal was 213 seconds (172-300, median 25-75%). The ED90 of sugammadex calculated by regression was 2.39mg/kg, with a 95% confidence interval of 2.27-2.46 mg/kg. Conclusion: the ED90 of sugammadex in patients with grade III obesity or higher was 2.39mg/kg.
Objetivos: determinar a ED90 (dose mínima eficaz em 90% dos pacientes) de sugamadex para a reversão de bloqueio neuromuscular (BNM) moderado induzido pelo rocurônio em pacientes com obesidade grau III submetidos à cirurgia bariátrica. Métodos: estudo prospectivo com o método de projeção sequencial para cima e para baixo da moeda enviesada. As seguintes doses foram escolhidas: 2,0mg/kg-1, 2,2mg/kg-1, 2,4mg/kg-1, 2,6mg/kg-1, 2,8mg/kg-1. A reversão completa de BNM induzido por rocurônio considerou uma relação T4/T1 ≥0,9 na medida do TOF. Após a indução da anestesia geral e calibração do estimulador de nervo periférico e acelerômetro, rocurônio 0,6mg/kg-1 foi injetado. Infusão contínua de propofol e remifentanil, e bolus intermitente de rocurônio foram injetados durante todo o procedimento. Resultados: trinta e um pacientes foram avaliados, 26 dos quais bem-sucedidos e cinco sem reversão completa do BNM moderado promovido pelo sugamadex. O tempo médio para completar reversão de BNM foi 213 segundos (172 a 300 segundos; mediana, 25-75%). O ED90 de sugamadex calculado pela regressão foi de 2,39mg/kg-1 com um intervalo de confiança de 95% (2,27 a 2,46mg/kg-1). Conclusão: o ED90 de sugamadex em pacientes com obesidade grau III ou superior foi 2,39mg/kg-1.
Asunto(s)
Androstanoles/uso terapéutico , Cirugía Bariátrica , Bloqueo Neuromuscular , Fármacos Neuromusculares no Despolarizantes/uso terapéutico , Obesidad/cirugía , gamma-Ciclodextrinas/administración & dosificación , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Rocuronio , SugammadexRESUMEN
BACKGROUND AND OBJECTIVES: The aim of our study is to compare the effects of sugammadex and neostigmine, used for neuromuscular blockage antagonism, on postoperative nausea and vomiting (PONV). METHODS: Our study was completed with 98 ASA I-II risk patients undergoing endotracheal intubation under general anesthesia. At the end of the surgery patients were randomly divided into two groups given 2mgkg-1 sugammadex (Group S) or 50µgkg-1 neostigmine plus 0.2mgkg-1 atropine (Group N). Monitoring and recording times were set as 1 hour postoperative and from 1-6, 6-12, and 12-24hours. The anti-emetic amounts administered were recorded. RESULTS: In the first hour postoperative 13 patients in Group N (27%) and 4 in Group S (8%) were observed to have nausea and/or vomiting and the difference was statistically significant (p=0.0016). During the 24 hours of monitoring there was no significant difference in the incidence and severity of PONV (p>0.05), however the number of patients given ondansetron for PONV treatment in Group N was statistically significantly higher than the number in Group S (16 in Group N, 6 in Group S, p<0.011). CONCLUSIONS: At the end of our study comparing neostigmine with sugammadex for neuromuscular blockage antagonism, we found use of sugammadex had lower incidence of PONV in the postoperative 1st hour and less anti-emetic use in 24 hours of monitoring.
Asunto(s)
Antieméticos/uso terapéutico , Neostigmina/administración & dosificación , Náusea y Vómito Posoperatorios/epidemiología , gamma-Ciclodextrinas/administración & dosificación , Adulto , Anestesia General/métodos , Antieméticos/administración & dosificación , Atropina/administración & dosificación , Quimioterapia Combinada , Femenino , Humanos , Incidencia , Intubación Intratraqueal , Masculino , Persona de Mediana Edad , Neostigmina/efectos adversos , Bloqueo Neuromuscular , Ondansetrón/administración & dosificación , Ondansetrón/uso terapéutico , Náusea y Vómito Posoperatorios/inducido químicamente , Estudios Prospectivos , Índice de Severidad de la Enfermedad , Método Simple Ciego , Sugammadex , gamma-Ciclodextrinas/efectos adversosRESUMEN
Myasthenia gravis is an autoimmune disorder that is characterized by muscle weakness that fluctuates, worsening with exertion, and improving with rest. Diagnosis of myasthenia gravis is made following clinical and physical examination and is confirmed by serum immunoassays to measure autoantibody levels. Myasthenia gravis especially when associated with pregnancy is a high-risk disease, and its course is unpredictable. We described the second report about use of sugammadex after rocuronium for a caesarean delivery with myasthenia gravis, but, unlike our case that formerly was diagnosed with myasthenia gravis, the patient was extubated on postoperative successfully and we did not encounter any respiratory problems.
Asunto(s)
Cesárea/métodos , Miastenia Gravis/fisiopatología , Complicaciones del Embarazo/fisiopatología , gamma-Ciclodextrinas/administración & dosificación , Adulto , Androstanoles/administración & dosificación , Femenino , Humanos , Embarazo , Rocuronio , Sugammadex , Resultado del TratamientoRESUMEN
ABSTRACT Objective: to determine the ED90 (minimum effective dose in 90% of patients) of sugammadex for the reversal of rocuronium-induced moderate neuromuscular blockade (NMB) in patients with grade III obesity undergoing bariatric surgery. Methods: we conducted a prospective study with the biased coin up-and-down sequential design. We chosen the following doses: 2.0mg/Kg, 2.2mg/Kg, 2.4mg/Kg, 2.6mg/Kg, 2.8mg/Kg. The complete reversal of rocuronium-induced NMB considered a T4/T1 ratio ≥0.9 as measured by TOF. After induction of general anesthesia and calibration of the peripheral nerve stimulator and accelerometer, we injected rocuronium 0.6mg/kg. We administered propofol and remifentanil by continuous infusion, and intermittent boluses of rocuronium throughout the procedure. Results: we evaluated 31 patients, of whom 26 had displayed successful reversal of the NMB with sugammadex, and failure in five. The mean time to complete moderate NMB reversal was 213 seconds (172-300, median 25-75%). The ED90 of sugammadex calculated by regression was 2.39mg/kg, with a 95% confidence interval of 2.27-2.46 mg/kg. Conclusion: the ED90 of sugammadex in patients with grade III obesity or higher was 2.39mg/kg.
RESUMO Objetivos: determinar a ED90 (dose mínima eficaz em 90% dos pacientes) de sugamadex para a reversão de bloqueio neuromuscular (BNM) moderado induzido pelo rocurônio em pacientes com obesidade grau III submetidos à cirurgia bariátrica. Métodos: estudo prospectivo com o método de projeção sequencial para cima e para baixo da moeda enviesada. As seguintes doses foram escolhidas: 2,0mg/kg-1, 2,2mg/kg-1, 2,4mg/kg-1, 2,6mg/kg-1, 2,8mg/kg-1. A reversão completa de BNM induzido por rocurônio considerou uma relação T4/T1 ≥0,9 na medida do TOF. Após a indução da anestesia geral e calibração do estimulador de nervo periférico e acelerômetro, rocurônio 0,6mg/kg-1 foi injetado. Infusão contínua de propofol e remifentanil, e bolus intermitente de rocurônio foram injetados durante todo o procedimento. Resultados: trinta e um pacientes foram avaliados, 26 dos quais bem-sucedidos e cinco sem reversão completa do BNM moderado promovido pelo sugamadex. O tempo médio para completar reversão de BNM foi 213 segundos (172 a 300 segundos; mediana, 25-75%). O ED90 de sugamadex calculado pela regressão foi de 2,39mg/kg-1 com um intervalo de confiança de 95% (2,27 a 2,46mg/kg-1). Conclusão: o ED90 de sugamadex em pacientes com obesidade grau III ou superior foi 2,39mg/kg-1.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Fármacos Neuromusculares no Despolarizantes/uso terapéutico , Bloqueo Neuromuscular , gamma-Ciclodextrinas/administración & dosificación , Cirugía Bariátrica , Androstanoles/uso terapéutico , Obesidad/cirugía , Estudios Prospectivos , Sugammadex , Rocuronio , Persona de Mediana EdadRESUMEN
Abstract Background: Intra-arterial injection of medications may cause acute and severe ischemia and result in morbidity and mortality. There is no information in the literature evaluating the arterial endothelial effects of sugammadex and dexmedetomidine. The hypothesis of our study is that sugammadex and dexmedetomidine will cause histological changes in arterial endothelial structure when administered intra-arterially. Methods: Rabbits were randomly divided into 4 groups. Group Control (n = 7); no intervention performed. Group Catheter (n = 7); a cannula inserted in the central artery of the ear, no medication was administered. Group Sugammadex (n = 7); rabbits were given 4 mg/kg sugammadex into the central artery of the ear, and Group Dexmedetomidine (n = 7); rabbits were given 1 µg/kg dexmedetomidine into the central artery of the ear. After 72 h, the ears were amputated and histologically investigated. Results: There was no significant difference found between the control and catheter groups in histological scores. The endothelial damage, elastic membrane and elastic fiber damage, smooth muscle hypertrophy and connective tissue increase scores in the dexmedetomidine and sugammadex groups were significantly higher than both the control and the catheter groups (p < 0.05). There was no significant difference found between the dexmedetomidine and sugammadex groups in histological scores. Conclusion: Administration of sugammadex and dexmedetomidine to rabbits by intra-arterial routes caused histological arterial damage. To understand the histological changes caused by sugammadex and dexmedetomidine more clearly, more experimental research is needed.
Resumo Justificativa: A injeção intra-arterial de medicamentos pode causar isquemia aguda e grave e resultar em morbidade e mortalidade. Não há informações na literatura que avaliem os efeitos endoteliais arteriais de sugamadex e dexmedetomidina. A hipótese de nosso estudo foi que dexmedetomidina e sugamadex causariam alterações histológicas na estrutura endotelial arterial quando administrados por via intra-arterial. Método: Os coelhos foram randomicamente divididos em quatro grupos: grupo controle (n = 7), sem intervenção; grupo cateter (n = 7), uma cânula foi inserida na artéria central da orelha e medicamentos não foram administrados; grupo sugamadex (n = 7), receberam 4 mg/kg de sugamadex na artéria central da orelha; grupo dexmedetomidina (n = 7), receberam 1 µg/kg de dexmedetomidina na artéria central da orelha. Após 72 horas, as orelhas foram amputadas e histologicamente examinadas. Resultados: Não houve diferença significativa entre os grupos controle e cateter referente aos escores histológicos. Os escores do dano causado ao endotélio e à membrana e fibra elásticas, da hipertrofia do músculo liso e do aumento do tecido conjuntivo foram significativamente maiores nos grupos dexmedetomidina e sugamadex do que nos grupos controle e cateter (p < 0,05). Não houve diferença significativa entre os grupos dexmedetomidina e sugamadex nos escores histológicos. Conclusão: A administração de sugamadex e dexmedetomidina a coelhos por via intra-arterial causou danos arteriais histológicos. Para entender as alterações histológicas causadas por sugamadex e dexmedetomidina com mais clareza, estudos experimentais adicionais são necessários.
Asunto(s)
Animales , Masculino , Endotelio Vascular/efectos de los fármacos , Dexmedetomidina/farmacología , gamma-Ciclodextrinas/farmacología , Hipnóticos y Sedantes/farmacología , Arterias/anatomía & histología , Arterias/efectos de los fármacos , Conejos , Endotelio Vascular/anatomía & histología , Dexmedetomidina/administración & dosificación , gamma-Ciclodextrinas/administración & dosificación , Oído Externo/irrigación sanguínea , Sugammadex , Hipnóticos y Sedantes/administración & dosificación , Inyecciones Intraarteriales , Músculo Liso Vascular/anatomía & histología , Músculo Liso Vascular/efectos de los fármacosRESUMEN
BACKGROUND: Intra-arterial injection of medications may cause acute and severe ischemia and result in morbidity and mortality. There is no information in the literature evaluating the arterial endothelial effects of sugammadex and dexmedetomidine. The hypothesis of our study is that sugammadex and dexmedetomidine will cause histological changes in arterial endothelial structure when administered intra-arterially. METHODS: Rabbits were randomly divided into 4 groups. Group Control (n=7); no intervention performed. Group Catheter (n=7); a cannula inserted in the central artery of the ear, no medication was administered. Group Sugammadex (n=7); rabbits were given 4mg/kg sugammadex into the central artery of the ear, and Group Dexmedetomidine (n=7); rabbits were given 1µg/kg dexmedetomidine into the central artery of the ear. After 72h, the ears were amputated and histologically investigated. RESULTS: There was no significant difference found between the control and catheter groups in histological scores. The endothelial damage, elastic membrane and elastic fiber damage, smooth muscle hypertrophy and connective tissue increase scores in the dexmedetomidine and sugammadex groups were significantly higher than both the control and the catheter groups (p<0.05). There was no significant difference found between the dexmedetomidine and sugammadex groups in histological scores. CONCLUSION: Administration of sugammadex and dexmedetomidine to rabbits by intra-arterial routes caused histological arterial damage. To understand the histological changes caused by sugammadex and dexmedetomidine more clearly, more experimental research is needed.
Asunto(s)
Dexmedetomidina/farmacología , Endotelio Vascular/efectos de los fármacos , Hipnóticos y Sedantes/farmacología , gamma-Ciclodextrinas/farmacología , Animales , Arterias/anatomía & histología , Arterias/efectos de los fármacos , Dexmedetomidina/administración & dosificación , Oído Externo/irrigación sanguínea , Endotelio Vascular/anatomía & histología , Hipnóticos y Sedantes/administración & dosificación , Inyecciones Intraarteriales , Masculino , Músculo Liso Vascular/anatomía & histología , Músculo Liso Vascular/efectos de los fármacos , Conejos , Sugammadex , gamma-Ciclodextrinas/administración & dosificaciónRESUMEN
Introducción: los bloqueantes neuromusculares y su reversión se utilizan de forma cotidiana en la práctica anestesiológica. Sin embargo, la parálisis muscular residual producida por dichas drogas debido a la reversión incompleta del fármaco, pueden producir complicaciones que pueden llegar a ser fatales. Objetivo: realizar una actualización sobre, si es conveniente o no, revertir el bloqueo neuromuscular.Desarrollo: la reversión del bloqueo neuromuscular por drogas anticolinesterásicas es dependiente de la labilidad de la acetilcolina para liberar los receptores ocupados por agentes bloqueantes neuromusculares no despolarizantes. El sugammadex, es una ciclodextrina tipo gamma modificada, que se diseñó para revertir el bloqueo neuromuscular profundo inducido por rocuronio. Su mecanismo de acción se produce por la alta afinidad y gran selectividad para encapsular la molécula de rocuronio. Una vez que se une al bloqueante neuromuscular ya no puede producir efecto. En muchas ocasiones, se revierten estos fármacos, sin tener en cuenta la respuesta individual, ni las interacciones farmacológicas, ni las dosis administradas y su frecuencia, ni si tienen efectos acumulativos, por sólo citar algunos. Conclusiones: el bloqueo neuromuscular y su recuperación ocurre en cada paciente individualmente tras la administración de agentes bloqueadores competitivos, donde la variación individual en la farmacología de estas drogas, no permiten predecir con exactitud sus efectos(AU)
Introduction: the bloqueantes neuromusculares and their reversion are used in a daily way in the practical anestesiológica. However, the residual muscular paralysis taken place by this drugs due to the incomplete reversion of the fármaco, complications that can end up being fatal can take place. Objective: to carry out an upgrade on, if it is convenient or not, to revert the blockade neuromuscular. Development: the reversion of the blockade neuromuscular for drugs anticolinesterásicas is dependent of the labilidad of the acetilcolina to liberate the receivers occupied by agents bloqueantes neuromusculares non despolarizantes. The sugammadex, is a ciclodextrina type modified gamma that was designed to revert the blockade deep neuromuscular induced by rocuronio. Their action mechanism takes place for the high likeness and great selectivity to encapsulate the rocuronio molecule. Once he/she unites to the bloqueante neuromuscular it can no longer produce effect. In many occasions, these fármacos is reverted, without keeping in mind the individual answer, neither the pharmacological interactions, neither the administered doses and their frequency, neither if they have accumulative effects, for only to mention some. Conclusions: the blockade neuromuscular and their recovery happens individually in each patient after the administration of competitive blocking agents, where the individual variation in the pharmacology of these drugs, they don't allow to predict with accuracy its effects(AU)
Asunto(s)
Humanos , Bloqueantes Neuromusculares/administración & dosificación , gamma-Ciclodextrinas/efectos adversos , gamma-Ciclodextrinas/administración & dosificación , Anestesiología/métodos , Fenómenos FarmacológicosRESUMEN
A burn patient is a challenge for any anesthesiologist, undergoing several surgeries during admission, and requiring general anesthesia and muscle relaxation most of the times. The victim may have respiratory system impairment and a response to muscle relaxants that differs from the healthy patient, thus proper monitoring and reversal is crucial. We analyzed sugammadex effectiveness and safety in this population. It was a prospectively descriptive study, including 4 patients, and all of them were considered major burn patients, who underwent escharotomy with general anesthesia and neuromuscular relaxation. The main variable was the time for recovery of a TOF higher than 0.9 after the administration of sugammadex before extubation. Mean time of recovery from a TOF ratio higher than 0.9 following the administration of Sugammadex was of 4.95 min 95% CI (3.25-6.64, The reversion of neuromuscular relaxation with sugammadex appears to be effective and safe in the burn patient. More analytical, comparative studies of larger populations would be necessary to confirm these data.
O paciente queimado representa um desafio para o anestesiologista, pois se submete a várias intervenções cirúrgicas durante sua hospitalização e necessita de anestesia geral e relaxamento muscular na maior parte delas. Apresenta sistema respiratório comprometido e uma resposta aos relaxantes musculares que difere do paciente sadio; portanto, um monitoramento correto e reversão tornam-se imprescindíveis. Avaliamos a eficácia e segurança do sugamadex nessa população. Estudo descritivo com caráter prospectivo que inclui quatro pacientes, todos eles considerados grandes queimados, submetidos a escarectomia com anestesia geral e relaxamento neuromuscular. Como variável principal tomou-se o tempo de recuperação de TOF superior a 0,9 após a administração de sugamadex antes de extubação. O tempo médio de recuperação de uma razão TOF superior a 0,9 após a administração de sugamadex foi de 4,95 minutos (IC95% 3,25-6,64; p = 0,53). A reversão do relaxamento neuromuscular com sugamadex parece ser eficaz e segura no paciente queimado. Seriam necessários mais estudos analíticos, comparativos e de maior população para confirmar esses dados.
El paciente quemado supone un reto para el anestesista, pues se somete a varias intervenciones quirúrgicas durante su ingreso, requiriendo anestesia general y relajación muscular en la mayor parte de ellas. Presentan un sistema respiratorio comprometido y una respuesta a los relajantes musculares que difiere de la del paciente sano, por lo que se hace imprescindible una correcta monitorización y reversión. Valoramos la efectividad y seguridad del sugammadex en esta población. Estudio descriptivo con carácter prospectivo que incluyó a 4 pacientes, todos ellos considerados grandes quemados, sometidos a escarectomía con anestesia general y relajación neuromuscular. Como variable principal se tomó el tiempo de recuperación de un TOF superior a 0,9 tras la administración de sugammadex previa a extubación. El tiempo medio de recuperación de un TOF ratio superior a 0,9 tras la administración de sugammadex fue de 4,95 min, IC al 95% (3,25-6,64; p = 0,53). La reversión de la relajación neuromuscular con sugammadex parece ser efectiva y segura en el paciente quemado. Serían necesarios más estudios de índole analítica, comparativa y de mayor población para confirmar dichos datos.
Asunto(s)
Humanos , Masculino , Femenino , Anciano , Quemaduras/cirugía , Fármacos Neuromusculares no Despolarizantes/administración & dosificación , gamma-Ciclodextrinas/administración & dosificación , Anestesia General/métodos , Quemaduras/fisiopatología , Estudios Prospectivos , gamma-Ciclodextrinas/efectos adversos , Monitoreo Neuromuscular/métodos , SugammadexRESUMEN
OBJECTIVES: A burn patient is a challenge for any anesthesiologist, undergoing several surgeries during admission, and requiring general anesthesia and muscle relaxation most of the times. The victim may have respiratory system impairment and a response to muscle relaxants that differs from the healthy patient, thus proper monitoring and reversal is crucial. We analyzed sugammadex effectiveness and safety in this population. MATERIALS AND METHODS: It was a prospectively descriptive study, including 4 patients, and all of them were considered major burn patients, who underwent escharotomy with general anesthesia and neuromuscular relaxation. The main variable was the time for recovery of a TOF higher than 0.9 after the administration of sugammadex before extubation. RESULTS: Mean time of recovery from a TOF ratio higher than 0.9 following the administration of Sugammadex was of 4.95min 95% CI (3.25-6.64, p=.53). CONCLUSIONS: The reversion of neuromuscular relaxation with sugammadex appears to be effective and safe in the burn patient. More analytical, comparative studies of larger populations would be necessary to confirm these data.
Asunto(s)
Anestesia General/métodos , Quemaduras/cirugía , Fármacos Neuromusculares no Despolarizantes/administración & dosificación , gamma-Ciclodextrinas/administración & dosificación , Anciano , Quemaduras/fisiopatología , Femenino , Humanos , Masculino , Monitoreo Neuromuscular/métodos , Estudios Prospectivos , Sugammadex , gamma-Ciclodextrinas/efectos adversosRESUMEN
Introducción: El bloqueo neuromuscular residual es causa de complicaciones postoperatorias. Objetivo: Identificar la eficacia del sugammadex para revertir el bloqueo neuromuscular con rocuronio, en procederes de larga duración, cuando éste se administra en forma de bolos versus infusión continua. Método: Se realizó un estudio descriptivo exploratorio en una serie de 10 pacientes para tratamiento quirúrgico de más de dos horas, de forma electiva con anestesia general en el Hospital General Universitario de Alicante, España, entre los meses de noviembre y diciembre del 2010. La inducción y el mantenimiento del bloqueo neuromuscular se realizaron mediante bolos (B) o infusión continua (IC), quedando los pacientes divididos en dos grupos. Se compararon los grupos según el tiempo de recuperación mediante la prueba de U-Mann Whitney. Resultados: Existió homogeneidad entre los grupos en cuanto a edad, peso corporal y estado físico según la ASA II III. La mediana del tiempo quirúrgico para el grupo B fue de 3:55 horas versus 4:20 horas en el grupo de infusión continua. Para alcanzar el cociente T4/T1 > 90%, la mediana del tiempo de recuperación fue de 75.0 minutos para el grupo IC, mientras en el grupo que se utilizaron bolos se observó un tiempo de 140.0 minutos; las diferencias entre ambos grupos resultaron ser estadísticamente significativas (p = 0,008). Conclusiones: La reversión del bloqueo neuromuscular de larga duración inducido por rocuronio fue más rápida cuando el sugammadex se administró en infusión continua en nuestro grupo de pacientes.
Asunto(s)
Androstanoles/administración & dosificación , Androstanoles/antagonistas & inhibidores , Bloqueo Neuromuscular/métodos , gamma-Ciclodextrinas/administración & dosificación , gamma-Ciclodextrinas/farmacología , Periodo de Recuperación de la Anestesia , Anestesia General/métodos , Vías de Administración de Medicamentos , Complicaciones Posoperatorias , Factores de TiempoRESUMEN
Introducción: El bloqueo neuromuscular residual es causa de complicaciones postoperatorias. Objetivo: Identificar la eficacia del sugammadex para revertir el bloqueo neuromuscular con rocuronio, en procederes de larga duración, cuando éste se administra en forma de bolos versus infusión continua. Método: Se realizó un estudio descriptivo exploratorio en una serie de 10 pacientes para tratamiento quirúrgico de más de dos horas, de forma electiva con anestesia general en el Hospital General Universitario de Alicante, España, entre los meses de noviembre y diciembre del 2010. La inducción y el mantenimiento del bloqueo neuromuscular se realizaron mediante bolos (B) o infusión continua (IC), quedando los pacientes divididos en dos grupos. Se compararon los grupos según el tiempo de recuperación mediante la prueba de U-Mann Whitney. Resultados: Existió homogeneidad entre los grupos en cuanto a edad, peso corporal y estado físico según la ASA II û III. La mediana del tiempo quirúrgico para el grupo B fue de 3:55 horas versus 4:20 horas en el grupo de infusión continua. Para alcanzar el cociente T4/T1 > 90%, la mediana del tiempo de recuperación fue de 75.0 minutos para el grupo IC, mientras en el grupo que se utilizaron bolos se observó un tiempo de 140.0 minutos; las diferencias entre ambos grupos resultaron ser estadísticamente significativas (p = 0,008). Conclusiones: La reversión del bloqueo neuromuscular de larga duración inducido por rocuronio fue más rápida cuando el sugammadex se administró en infusión continua en nuestro grupo de pacientes. (AU)