Sugammadex

Neuromuscular blocking agents (NMBAs) and antibiotics are the most common triggers of intraoperative anaphylaxis. Sugammadex, a modified γ-cyclodextrin, rapidly reverses aminosteroid NMBAs (rocuronium and vecuronium) and acts 3 to 8 times faster than neostigmine.1 It has a good safety profile and has been licensed in more than 70 countries. However, the US Food and Drug Administration (FDA) approved it only recently in December 2015.2 Anaphylaxis to this drug occurs rarely, estimated at 29 per 1,000,000 population, usually at the end of anesthesia when sugammadex is used for NMBA reversal.

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