舒更葡糖是一種改良的γ-環糊精，用於拮抗類固醇非去極化神經肌肉阻滯藥物羅庫溴銨和維庫溴銨。
對接受脊柱手術的老年患者使用舒更葡萄或新斯的明拮抗羅庫溴銨後恢復情況的比較：一項隨機對照試驗
目的：
比較舒更葡萄與新斯的明拮抗對老年腰椎後路手術患者羅庫溴銨神經肌肉阻滯（NMB）後恢復速度和質量的影響。
方法：
在一家三級學術醫療中心進行的隨機對照研究，涉及40名患者（年齡≥65歲，ASA PS II/III）計劃在全身麻醉下進行擇期手術。
患者被隨機分為舒更葡萄或新斯的明組，用於拮抗中度的羅庫溴銨神經肌肉阻滯作用。
主要結果是術後從NMB恢復到TOF（四個成串刺激）比率≥0.9的時間，TOF測量部位：拇內收肌（TOF WatchSX）。
次要結果包括服用拮抗劑後的
血流動力學變化（心率、血壓、心律失常）、
拔管時間、
止痛藥需求、
首次行走時間、
麻醉後復甦室（PACU）的時間，
總住院時間。
結果：
舒更葡萄組恢復到TOF比率≥0.9的時間為4±2.2min，而新斯的明組為26.3±17.5min，平均快22min（95%CI：14.1-30.5；P≤0.001），變異性也較小（範圍為2-11分鐘vs 5-72分鐘）。
兩組在氣管拔管時間、對口頭命令的反應（睜眼、捏手、抬頭）和手術室出室時間方面存在顯著差異。
然而，他們有相似的PACU時間、總住院時間、術後疼痛和阿片類藥物使用。
舒更葡萄的血流動力學指標及首次行走時間變異性比新斯的明小。
沒有患者出現治療引起的心律失常。
結論：
與新斯的明相比，舒更葡萄拮抗顯著加快了老年患者神經肌肉阻滯的恢復。它顯著減少了手術室時間，但沒有減少PACU時間或住院時間。
Comparison of recovery after sugammadex or neostigmine reversal of rocuronium in geriatric patients undergoing spine surgery: a randomized controlled trial
Aim:
To evaluate the effect of sugammadex compared with neostigmine on speed and quality of recovery after rocuronium neuromuscular blockade (NMB) in geriatric patients undergoing posterior lumbar spine surgery.
Methods:
This randomized controlled study at a tertiary academic medical center involved 40 patients (age ≥65 years, ASA PS II/III) scheduled for elective surgery under general anesthesia. Patients were randomized to sugammadex or neostigmine for reversal of moderate NMB with rocuronium. The primary outcome was recovery time from NMB after surgery to a train-of-four (TOF) ratio ≥0.9 measured at the adductor pollicis (TOF-Watch SX). Secondary outcomes included hemodynamic change after administration of reversal agent (heart rate, blood pressure, dysrhythmia), time to extubation, pain medication requirement, time to first ambulation, and length of postanesthesia care unit (PACU) and total hospital stay.
Results:
Sugammadex (4±2.2 min) compared with neostigmine reversal (26.3±17.5 min) was on average 22 min faster (95% CI 14.1-30.5; P≤0.001) with less variability (range 2-11 min vs 5-72 min). The groups significantly differed in time for tracheal extubation, response to verbal commands (open eyes, squeeze hand, lift head), and operating room exit. However, they had similar PACU stay, time to first ambulation, total hospital stay, postoperative pain, and opioid use. Sugammadex had less hemodynamic variability than neostigmine. No patient developed treatment-emergent dysrhythmias.
Conclusion:
Sugammadex reversal significantly hastened NMB recovery compared with neostigmine reversal in geriatric patients. It significantly decreased operating room time but not PACU time or hospital stay.
