Background: Sugammadex reverses neuromuscular block (NMB) through binding aminosteroid neuromuscular\nblocking agents. Although sugammadex appears to be highly selective, it can interact with other drugs, like\ncorticosteroids. A prospective single-blinded randomized clinical trial was designed to explore the significance\nof interactions between dexamethasone and sugammadex.\nMethods: Sixty-five patients who were anesthetized for elective abdominal or urological surgery were included.\nNMB was assessed using train-of-four stimulation (TOF), with rocuronium used to maintain the desired NMB depth.\nNMB reversal at the end of anaesthesia was achieved using sugammadex. According to their received antiemetics,\nthe patients were randomized to either the granisetron or dexamethasone group. Blood samples were taken before\nand after NMB reversal, for plasma dexamethasone and rocuronium determination. Primary endpoint was time from\nsugammadex administration to NMB reversal. Secondary endpoints included the ratios of the dexamethasone and\nrocuronium concentrations after NMB reversal versus before sugammadex administration.\nResults: There were no differences for time to NMB reversal between the control (mean 121 Ã?± 61 s) and the\ndexamethasone group (mean 125 Ã?± 57 s; P = 0.760). Time to NMB reversal to a TOF ratio ââ?°Â¥0.9 was significantly\nlonger in patients with lower TOF prior to sugammadex administration (Beta = âË?â??0.268; P = 0.038). The ratio between\nthe rocuronium concentrations after NMB reversal versus before sugammadex administration was significantly\naffected by sugammadex dose (Beta = âË?â??0.375; P = 0.004), as was rocuronium dose per hour of operation (Beta = âË?â??0.\n366; p = 0.007), while it was not affected by NMB depth before administration of sugammadex (Beta = âË?â??0.089; p = 0.\n483) and dexamethasone (Beta = âË?â??0.186; p = 0.131). There was significant drop in plasma dexamethasone after\nsugammadex administration and NMB reversal (p < 0.001).\nConclusions: Administration of dexamethasone to anesthetized patients did not delay NMB reversal by sugammadex
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