Resumen de Sugammadex 50 mg/5 ml allows clinicians rationalize its use for residual neuromuscular blockade reversal

Anna Faura Messa, Tomás Casasin, Domingo Blanco Vargas, Raúl Rigo Bonnin

• Introduction: Sugammadex reverses very effciently residual rocuronium-induced neuromuscular block at doses range 0.5-1 mg/kg. The current cost of a 200 mg-vial sugammadex (the smallest marketed unit dose) is €71. No previous studies have been performed with lower total milligram unit doses with a proportionally reduced price.

  The objectives of this study were to evaluate the cost of 50 mg unit dose and to demonstrate the stability of 50 mg/5 ml pre-filled syringes.

  Method: Retrospective, observational study was performed in a 117-bed primary hospital. Since 2014, the Pharmacy Department provides surgical areas with sugammadex 200 mg vials and 50 mg unit doses. We compared a cohort of patients scheduled for elective surgery under general anesthesia who received sugammadex for neuromuscular reversion before (2013) and after sugammadex 50 mg/5 ml syringes implementation (2014). Clinical Laboratory studied its time stability by Ultra Performance Liquid Chromatography.

  Results: No differences between the number and type of surgical procedures were found in 2013 and 2014. In 2014, sugammadex consumption decreased from 880 vials to 140 vials and 700 pre-filled syringes, which represented a cost saving of €33,866. The proportion of syringes versus vials increased progressively in 2015 and 2016.

  Fifty mg/5 ml sugammadex syringes maintained its stability at least for 60 days. Conclusions: Sugammadex 50 mg/5 ml syringes are stable for at least 60 days and allows clinicians to rationalize its use, which represents a significant saving