Sugammadex and fast-Track anesthesia for pediatric cardiac surgery in a developing country

David P. Martin, Jack Crawford, Joshua Uffman, Robert Michler, Joseph D. Tobias

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Objective: There are several physiologic advantages to early tracheal extubation and spontaneous ventilation following surgery for congenital heart disease (CHD). In order for early tracheal extubation to be feasible, effective reversal of neuromuscular blockade is mandatory. Sugammadex reverses neuromuscular blockade with a mechanism that differs from acetylcholinesterase inhibitors. We aimed to study the effect of sugammadex on the fast track extubation. Methodology: We retrospectively reviewed our experience with the use of sugammadex to reverse neuromuscular blockade following cardiac surgery for CHD in infants and children, during a pediatric cardiac surgical trip of Heart Care International to Tuxtla, Mexico. Demographic data collected included age, weight, type of CHD, and the surgical procedure. Intraoperative data included sugammadex dose, outcome (successful tracheal extubation), and adverse effects, which could be attributed to sugammadex. Sugammadex was administered to 14 patients, who ranged in age from 1 to 16 years of age and in weight from 7.6 to 57.7 kilograms. Statistical analysis was done Results: All 14 patients underwent successful tracheal extubation in the operating room within 15 min of completion of the surgical procedure. No patient required reintubation of the trachea during the postoperative course. No adverse effects related to sugammadex were noted. Conclusions: Our preliminary experience demonstrates that sugammadex effectively reverses neuromuscular blockade and allows for early tracheal extubation in pediatric patients following surgery for repair of CHD. Prompt and effective reversal of neuromuscular blockade allows for effective fast-Tracking with early tracheal extubation.

Original languageEnglish (US)
Pages (from-to)S17-S22
JournalAnaesthesia, Pain and Intensive Care
StatePublished - Oct 2016


  • Acetylcholinesterase inhibitors
  • Cardiac surgery
  • Congenital heart disease
  • Neuromuscular blockade
  • Sugammadex
  • Tracheal extubation

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Anesthesiology and Pain Medicine


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