Sugammadex

Mechanism of action

Modified gamma-cyclodextrin that encapsulates rocuronium (and, less tightly, vecuronium) in plasma, pulling the drug off the neuromuscular junction. Works at any depth of block, without anticholinesterase side effects.

Dosing

Adult

2 mg/kg if 2 twitches on train-of-four; 4 mg/kg for deep block (1–2 post-tetanic counts); 16 mg/kg for immediate reversal 3 minutes after rocuronium 1.2 mg/kg

Pediatric

Age ≥2: 2 or 4 mg/kg as for adults

Dose on actual body weight.