{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T16:48:14Z","timestamp":1790786894746,"version":"4.1.0"},"reference-count":21,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,12,17]],"date-time":"2021-12-17T00:00:00Z","timestamp":1639699200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009947","name":"Merck Sharp and Dohme","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009947","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Few randomized studies have assessed recovery from rocuronium\u2010 or vecuronium\u2010induced moderate or deep neuromuscular blockade with sugammadex in pediatric participants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To assess sugammadex for reversal of neuromuscular blockade in pediatric participants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a randomized, phase IV, active comparator\u2010controlled, double\u2010blind study. Participants aged 2 to &lt;17\u00a0years, under moderate or deep neuromuscular blockade, were administered sugammadex (2 or 4\u00a0mg\/kg) or neostigmine (50\u00a0\u00b5g\/kg; for moderate neuromuscular blockade only). Predefined adverse events of clinical interest, including clinically relevant bradycardia, hypersensitivity, and anaphylaxis, were monitored. The primary efficacy endpoint was time to recovery to a train\u2010of\u2010four ratio of \u22650.9 in participants receiving sugammadex 2\u00a0mg\/kg versus neostigmine for reversal of moderate neuromuscular blockade, analyzed by analysis of variance adjusted for neuromuscular blocking agent and age.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 288 randomized participants, 272 completed the study and 276 were included in the analyses. Clinically relevant bradycardia was experienced by 2.0%, 1.6%, and 5.9% of participants in the sugammadex 2\u00a0mg\/kg, sugammadex 4\u00a0mg\/kg, and neostigmine groups, respectively. No hypersensitivity or anaphylaxis events were observed. Recovery to a train\u2010of\u2010four ratio of \u22650.9 with sugammadex 2\u00a0mg\/kg was faster than neostigmine (1.6\u00a0min, 95% CI 1.3 to 2.0 vs. 7.5\u00a0min, 95% CI 5.6 to 10.0; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.0001) and was comparable to sugammadex 4\u00a0mg\/kg (2.0\u00a0min, 95% CI 1.8 to 2.3).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Pediatric participants recovered from rocuronium\u2010 or vecuronium\u2010induced moderate neuromuscular blockade significantly faster with sugammadex 2\u00a0mg\/kg than with neostigmine. Time to reversal of deep neuromuscular blockade with sugammadex 4\u00a0mg\/kg was consistent with that of moderate neuromuscular blockade reversal. No meaningful differences in clinically relevant bradycardia, hypersensitivity, or anaphylaxis were seen with sugammadex vs neostigmine. These results support the use of sugammadex for reversal of moderate and deep rocuronium\u2010 and vecuronium\u2010induced neuromuscular blockade in patients aged 2 to &lt;17\u00a0years.<\/jats:p><jats:p><jats:bold>Clinical Trial Registration:<\/jats:bold> NCT03351608\/EudraCT 2017\u2010000692\u201092.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pan.14370","type":"journal-article","created":{"date-parts":[[2021,12,8]],"date-time":"2021-12-08T16:19:25Z","timestamp":1638980365000},"page":"436-445","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Sugammadex for reversal of neuromuscular blockade in pediatric patients: Results from a phase IV randomized study"],"prefix":"10.1111","volume":"32","author":[{"given":"Tiffini","family":"Voss","sequence":"first","affiliation":[{"name":"Department of Clinical Research Merck &amp; Co., Inc.  Kenilworth New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aobo","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Clinical Research Merck &amp; Co., Inc.  Kenilworth New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"DeAngelis","sequence":"additional","affiliation":[{"name":"Department of Clinical Research Merck &amp; Co., Inc.  Kenilworth New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel","family":"Speek","sequence":"additional","affiliation":[{"name":"Department of Clinical Research Merck &amp; Co., Inc.  Kenilworth New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vera","family":"Saldien","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Antwerp University Hospital Edegem and University of Antwerp  Antwerp Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7193-3938","authenticated-orcid":false,"given":"Gregory B.","family":"Hammer","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics and Anesthesiology, Perioperative and Pain Medicine Stanford University School of Medicine  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Wrishko","sequence":"additional","affiliation":[{"name":"Department of Clinical Research Merck &amp; Co., Inc.  Kenilworth New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9133-031X","authenticated-orcid":false,"given":"W. Joseph","family":"Herring","sequence":"additional","affiliation":[{"name":"Department of Clinical Research Merck &amp; Co., Inc.  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