Stick With Neostigmine for Most Neuromuscular Blockade Reversal

Sugammadex (Bridion, BRID-ee-un) will be the first neuromuscular blocker (NMB) reversal agent approved in the U.S. in 30 years.

We usually see neostigmine given to reverse NMBs (rocuronium, etc). Muscarinic blockers (glycopyrrolate, atropine) must also be given to limit neostigmine's side effects...hypotension, bradycardia, etc.

But some anesthesiologists don't like that neostigmine can take 20 minutes to work and may result in residual blockade.

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