Sugammadex: Safety Profile and Adverse Effects in Infants Less Than Two Years of Age With Congenital Heart Disease.
Bradycardia was low and comparable in infants receiving sugammadex or neostigmine.
Sugammadex: Safety Profile and Adverse Effects in Infants Less Than Two Years of Age With Congenital Heart Disease.
Despite widespread clinical use and Food and Drug Administration (Food and Drug Administration) approval for use in patients from birth to < 2 years old in 2024, data regarding the safety and monitoring practices of sugammadex in infants with congenital heart disease (congenital heart disease) remains limited.
The current study retrospectively evaluated a random sample of patients over a 10-year period to determine the efficacy, perioperative adverse effects, and neuromuscular monitoring practices associated with the administration of reversal agents for neuromuscular blocking agents in patients less than 2 years of age with congenital heart disease.
The study cohort included 497 encounters across 375 unique patients with a median age of 7 months who received either sugammadex or neostigmine, which served as a historical comparator.
Successful tracheal extubation was achieved in over 90% of encounters, with a similar rate between groups.
Rate of residual neuromuscular blockade was also comparable between groups, though quantitative train-of-four (TOF) monitoring was inconsistently documented.
Furthermore, wide variability in sugammadex dosing was observed, highlighting an opportunity for standardization in this high-risk pediatric population.
In the current cohort of infants with congenital heart disease, sugammadex was associated with a low incidence of perioperative adverse effects and rates of successful tracheal extubation similar to neostigmine.
These patterns held despite higher ASA status among patients receiving sugammadex, which suggests greater baseline illness severity.
Observed adverse events were heterogeneous and likely reflect the underlying clinical context in addition to any reversal agent effects.