Emerging considerations in the reversal of neuromuscular blockade and residual block

Incomplete recovery following reversal of neuromuscular blockade can present as a clinical problem in surgical patients. Emerging pharmacologic solutions may prevent such adverse outcomes in the future. We briefly review two methods of pharmacologic reversal of neuromuscular blockade. Both methods of reversal are effective. However the early studies of the new compound, sugammadex has been shown to achieve a more rapid, stable reversal of steroidal based neuromuscular blocking agents compared to neostigmine. Due to the novel mechanism of action of this agent, sugammadex has been demonstrated to be effective even when administered during profound neuromuscular block, without evidence of recurarization.