Characteristics and effectiveness of sugammadex

: Sugammadex was synthesized as a selective reversal agent for rocuronium, a steroidal non-depolarizing neuromuscular blocking (NMB) agent. Sugammadex exerts its effect by forming very tight water-soluble complexes at a 1 : 1 ratio with steroidal NMB agents. Because the reversal of NMB could not sufficiently be completed by anti-cholinesterase agents such as neostigmine, we often had to wait until their spontaneous recovery. Sugammadex altered the situation because of its rapid and potent antagonistic action. The rapid reversal can be explained by rapid redistribution of free rocuronium from the neuromuscular junction to the plasma. The reversal effects are not influenced by anesthetics. There is no interaction with cholinergic systems. Therefore, undesired side effects attendant with anti-cholinesterases are not seen. This article provides information on the characteristics and effectiveness of sugammadex.