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This study aimed to evaluate the efficacy and safety of adamgammadex versus sugammadex in reversing deep rocuronium\u2010induced NMB. This multicenter, randomized, phase IIb study included 80 patients aged 18\u201364\u2009years, American Society of Anesthesiologists (ASA) grade 1\u20132, undergoing elective surgery under general anesthesia with rocuronium. Patients were randomized to the adamgammadex 7, 8, and 9\u2009mg\/kg group or the sugammadex 4\u2009mg\/kg group. The primary efficacy variable was the time to recovery of train\u2010of\u2010four ratio (TOFr) to 0.9. The secondary efficacy variables were the time to recovery of TOFr to 0.7, antagonistic success rate of the recovery of TOFr to 0.9 within 5\u2009min, and incidence rate of recurarization within 30\u2009min after drug administration. The explorative efficacy variable was the time to recovery of the corrected TOFr to 0.9 (actual\/baseline TOF ratio). Adamgammadex 7, 8, and 9\u2009mg\/kg and sugammadex 4\u2009mg\/kg groups did not significantly differ in all efficacy variables. Importantly, adamgammadex 9\u2009mg\/kg permitted reversal within a geometric mean of 2.9\u2009min. According to the safety profile, adamgammadex achieved good tolerance and low incidence of drug\u2010related adverse events compared with the 4\u2009mg\/kg sugammadex. Adamgammadex 7, 8, and 9\u2009mg\/kg facilitated rapid reversal of deep rocuronium\u2010induced NMB and had good tolerance and low incidence of drug\u2010related adverse events. Therefore, adamgammadex is a potential and promising alternative to sugammadex.<\/jats:p>","DOI":"10.1111\/cts.13691","type":"journal-article","created":{"date-parts":[[2024,1,12]],"date-time":"2024-01-12T13:49:56Z","timestamp":1705067396000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Efficacy and safety of adamgammadex for reversing rocuronium\u2010induced deep neuromuscular blockade: A\u00a0multicenter, randomized, phase IIb study"],"prefix":"10.1111","volume":"17","author":[{"given":"Yanhua","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Ren Ji Hospital Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sifan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Ren Ji Hospital Shanghai Jiao Tong University School of Medicine  Shanghai 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