Rapid neuromuscular block reversal at the end of major abdominal surgery is recommended to avoid any postoperative residual block. To date, no study has evaluated sugammadex performance after rocuronium administration in patients undergoing liver transplantation. This is a randomized controlled trial with the primary objective of assessing the neuromuscular transmission recovery time obtained with sugammadex versus neostigmine after rocuronium induced neuromuscular blockade in patients undergoing orthotopic liver transplantation. The TOF-Watch SX®, calibrated and linked to a portable computer equipped with TOF-Watch SX Monitor Software®, was used to monitor and record intraoperative neuromuscular block maintained with a continuous infusion of rocuronium. Anaesthetic management was standardized as per our institution’s internal protocol. At the end of surgery, neuromuscular moderate block reversal was obtained by administration of 2 mg/kg of sugammadex or 50 mcg/kg of neostigmine (plus 10 mcg/kg of atropine). Data from 41 patients undergoing liver transplantation were analysed. In this population, recovery from neuromuscular block was faster following sugammadex administration than neostigmine administration, with mean times±SD of 9.4 ± 4.6 min and 34.6 ± 24.9 min, respectively (p < 0.0001). Sugammadex is able to reverse neuromuscular block maintained by rocuronium continuous infusion in patients undergoing liver transplantation. The mean reversal time obtained with sugammadex was significantly faster than that for neostigmine. It is important to note that the sugammadex recovery time in this population was found to be considerably longer than in other surgical settings, and should be considered in clinical practice. ClinicalTrials.govNCT02697929 (registered 3rd March 2016).

中文翻译：

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接受肝移植的患者连续输注罗库溴铵后舒更葡糖与新斯的明的比较。

建议在腹部大手术结束时快速逆转神经肌肉阻滞，以避免术后残留阻滞。迄今为止，尚无研究评估接受肝移植的患者服用罗库溴铵后舒更葡糖的表现。这是一项随机对照试验，主要目的是评估接受原位肝移植的患者在罗库溴铵诱导神经肌肉阻滞后，使用舒更葡糖与新斯的明获得的神经肌肉传输恢复时间。TOF-Watch SX® 经过校准并连接到配备 TOF-Watch SX Monitor Software® 的便携式计算机，用于监测和记录持续输注罗库溴铵维持的术中神经肌肉阻滞。根据我们机构的内部协议，麻醉管理已标准化。手术结束时，通过给予 2 mg/kg 舒更葡糖或 50 mcg/kg 新斯的明（加上 10 mcg/kg 阿托品）获得神经肌肉中度阻滞逆转。分析了 41 名接受肝移植的患者的数据。在该人群中，给予舒更葡糖后神经肌肉阻滞的恢复比给予新斯的明更快，平均时间±SD 分别为 9.4 ± 4.6 分钟和 34.6 ± 24.9 分钟（p < 0.0001）。Sugammadex 能够逆转接受肝移植的患者持续输注罗库溴铵所维持的神经肌肉阻滞。舒更葡糖获得的平均逆转时间明显快于新斯的明。值得注意的是，该人群的舒更葡糖恢复时间比其他手术环境要长得多，在临床实践中应予以考虑。ClinicalTrials.govNCT02697929（2016 年 3 月 3 日注册）。