***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND : Sugammadex , a specifically design ed & ggr;-cyclodextrin , is a selective relaxant binding drug that rapidly reverses rocuronium-induced and , to a lesser extent , vecuronium-induced neuromuscular blockade . In this study , we compared the efficacy of sugammadex and neostigmine for the reversal of vecuronium-induced neuromuscular blockade in patients scheduled for elective surgery . METHODS : Patients aged ≥18 yr , ASA Class I – III , and scheduled for a surgical procedure under sevoflurane/opioid anesthesia  received an intubating dose of vecuronium ( 0.1 mg/kg ) and maintenance doses of 0.02–0.03 mg/kg at reappearance of the second twitch ( T2 ) of train-of-four ( TOF ) if required . Neuromuscular blockade was monitored using acceleromyography ( TOF-Watch ® SX , Schering-Plough Irel and , Dublin , Irel and ) . At end of surgery , at reappearance of T2 after the last dose of vecuronium , patients were r and omized to receive either sugammadex ( 2 mg/kg ) or neostigmine ( 50 & mgr;g/kg ) plus glycopyrrolate ( 10 & mgr;g/kg ) IV . The primary efficacy end-point was time from start of administration of sugammadex or neostigmine to recovery of TOF ratio to 0.9 . RESULTS : The geometric mean time to recovery of the TOF ratio to 0.9 was significantly faster with sugammadex compared with neostigmine ( 2.7 min [ 95 % confidence interval { CI } ] : 2.2–3.3 ) versus 17.9 min [ 95 % CI : 13.1–24.3 ] , respectively ; P < 0.0001 ) . The mean recovery times to a TOF ratio of 0.8 and 0.7 were also significantly shorter with sugammadex . No serious adverse events or unexpected side effects were reported with either drug . CONCLUSION : Sugammadex provided significantly faster reversal of vecuronium-induced neuromuscular blockade compared with neostigmine BACKGROUND : The reversal of a deep neuromuscular blockade remains a significant clinical problem . Sugammadex , a modified & ggr;-cyclodextrin , encapsulates steroidal neuromuscular blocking drugs , promoting their rapid dissociation from nicotinic receptors . Sugammadex is the first drug that acts as a selective relaxant binding agent . METHODS : We enrolled 50 patients into a Phase II dose-finding study of the efficacy and safety of sugammadex .  Subjects , anesthetized with nitrous oxide and propofol  , were r and omized to one of two doses of rocuronium ( 0.6 or 1.2 mg/kg ) and to one of five doses of sugammadex ( 0.5 , 1.0 , 2.0 , 4.0 , or 8.0 mg/kg ) .  Neuromuscular monitoring was performed using the TOF Watch SX ® acceleromyograph . Recovery was defined as a train-of-four ratio ≥0.9 . Sugammadex was administered during profound block when neuromuscular monitoring demonstrated a posttetanic count of one or two . RESULTS : Reversal of neuromuscular block was obtained after administration of sugammadex in all but the lowest dose groups ( 0.5–1.0 mg/kg ) where several subjects could not be adequately reversed . At the 2 mg/kg dose all patients were reversed with sugammadex , but there was significant variability ( 1.8–15.2 min ) . Patient variability decreased and speed of recovery increased in a dose-dependent manner . At the highest dose ( 8 mg/kg ) , mean recovery time was 1.2 min ( range 0.8–2.1 min ) . No serious adverse events were reported during this trial . CONCLUSIONS : Sugammadex was well tolerated and effective in rapidly reversing profound rocuronium-induced neuromuscular block . The mean time to recovery decreased with increasing doses . Profound rocuronium-induced neuromuscular block can be reversed successfully with sugammadex at doses ≥2 mg/kg OBJECTIVE To determine if reversing a deep or moderate block with sugammadex , compared with a shallow block reversed with neostigmine , reduces the time to operating room discharge after surgery and the time spent in the postanesthesia care unit . DESIGN A r and omized controlled trial . SETTING Monocentric study performed from February 2011 until May 2012 . PATIENTS One hundred consenting women with American Society of Anesthesiologists grade I or II were r and omized into 2 groups . INTERVENTION  Laparoscopic hysterectomy was performed under desflurane general anesthesia . For the neostigmine ( N ) group , 0.45 mg · kg-1 rocuronium was followed by spontaneous recovery . A 5-mg rescue bolus was administered only if surgical evaluation was unacceptable . At the end of surgery , 50 μg · kg-1 neostigmine with glycopyrrolate was administered . For the sugammadex ( S ) group , a higher intubating rocuronium dose ( 0.6 mg · kg-1 ) was followed by 5-mg boluses each time the train-of-four count exceeded 2 . Sugammadex ( 2 - 4 mg · kg-1 ) was administered to reverse the block . All patients were extubated after obtaining a train-of-four ratio of 0.9 . MEASUREMENTS The duration between the end of surgery and operating room discharge and the time spent in the postanesthesia care unit . MAIN RESULTS The time till operating room discharge was shorter and more predictable in group S ( 9.15±4.28 minutes vs 13.87±11.43 minutes in group N ; P=.005 ) . The maximal duration in group S was 22 minutes , compared with 72 minutes in group N. The time spent in the postanesthesia care unit was not significantly different ( group S : 47.75±31.77 minutes and group N : 53.43±40.57 minutes ; P=.543 ) . CONCLUSION Maintaining a deep neuromuscular block during laparoscopic hysterectomy reversed at the end of the procedure with sugammadex enabled a faster and more predictable time till operating room discharge than did the classical combination of a shallower block reversed with neostigmine Background Sugammadex reverses the effects of rocuronium- and vecuronium-induced neuromuscular blockade , which are achieved by encapsulation . It is known that some non-antiarrhythmic drugs have the potential to delay cardiac repolarization and it is therefore recommended that the effects of all new drugs on the QT interval are assessed . Objective This thorough corrected QT ( QTc ) study evaluated the effect of sugammadex alone and in combination with rocuronium or vecuronium on the individually corrected QTc interval ( QTcI ) . Methods This was a r and omized , double-blind , six-period crossover , placebo-controlled study , with an open-label active-controlled component ( moxifloxacin ) . The study was design ed according to International Conference on Harmonization ( ICH ) E14 guidelines . The study was conducted in a clinical research unit from November 2006 to April 2007 . Healthy male and female subjects ( n = 84 ) were enrolled in the study . Subjects were r and omized to six treatment sequences comprising single intravenous doses of placebo , moxifloxacin 400 mg ( positive control ) , sugammadex 4 mg/kg , sugammadex 32 mg/kg , sugammadex 32 mg/kg with rocuronium 1.2 mg/kg and sugammadex 32 mg/kg with vecuronium 0.1 mg/kg . Triplicate ECGs were recorded at 13 timepoints up to 23.5 hours after study drug administration and QT intervals were evaluated manually under blinded conditions . The primary outcome was the largest time-matched mean difference in QTcI change from baseline compared with placebo across the 13 timepoints up to 23.5 hours after study drug administration . Blood sample s were also collected for pharmacokinetic analysis . Results Of the 84 r and omized healthy subjects , 80 completed the study .  After moxifloxacin , QTcI prolongations were observed compared with placebo ; the lower limit of the one-sided 95 % confidence interval ( CI ) for the largest time-matched mean difference in QTcI change compared with placebo was 20.8 msec ( 90 % CI 18.5 , 23.1 ) , thus exceeding the ICH E14 safety margin of 5 msec and demonstrating assay sensitivity . In contrast , the largest time-matched mean difference in QTcI ( msec ) from placebo with sugammadex treatments ranged from 2.1 ( sugammadex 4 mg/kg alone ) to 4.3 ( sugammadex 32 mg/kg with vecuronium 0.1 mg/kg ) . For the largest time-matched mean difference in QTcI change compared with placebo the corresponding upper limit of the one-sided 95 % CI was well below the 10 msec margin for both sugammadex doses . Telemetry results revealed that one subject experienced a non-sustained ventricular tachycardia 4 hours after sugammadex 32 mg/kg , which was self-terminating after 20 beats and considered unlikely to be drug related . Pharmacokinetic-QTc analysis showed a statistically significant ( p<0.01 ) relationship between  sugammadex plasma concentration and QTcI ; however , at mean maximum plasma concentrations of the therapeutic and supratherapeutic sugammadex dose , the predicted one-sided upper 95 % CI for the largest time-matched QTcI difference from placebo was below 10 msec . Rocuronium or vecuronium co-administration did not affect the relationship between sugammadex concentrations and QTc . Conclusions Based on the results of this study of healthy subjects , it can be concluded that sugammadex alone or in combination with rocuronium or vecuronium is not associated with QTc prolongation In this study we investigated whether the novel reversal drug , sugammadex , is equally effective at reversing rocuronium-induced neuromuscular block ( NMB )  in patients under propofol or sevoflurane maintenance anesthesia . After receiving propofol for induction , patients were r and omized to propofol ( n = 21 ) or sevoflurane ( n = 21 ) .  Rocuronium 0.6 mg/kg was administered for tracheal intubation . NMB was monitored using acceleromyography . At reappearance of the second twitch of the train-of-four ratio , sugammadex 2.0 mg/kg was administered by IV bolus . The primary end-point was time from start of sugammadex administration to recovery of train-of-four ratio to 0.9 . Mean recovery time was 1.8 min after both propofol and sevoflurane anesthesia . The 95 % confidence interval for the difference in recovery time between the 2 groups ( –0.5 to + 0.4 min ) was well within the predefined equivalence interval ( –1 to + 1 min ) , indicating that recovery from NMB was unaffected by maintenance anesthesia . Thirteen patients ( propofol n = 4 ; sevoflurane n = 9 ) experienced adverse events ; these were treatment-related in 4 patients ( propofol n = 3 ; sevoflurane n = 1 ) . There were no treatment-related serious adverse events and no discontinuations or deaths . No residual paralysis occurred . The safety profile of sugammadex  was somewhat more favorable under propofol than under sevoflurane anesthesia Background We evaluated the potential for QT/corrected QT ( QTc ) interval prolongation after sugammadex given with propofol or sevoflurane anaesthesia . Methods This was a two-factorial , r and omized , parallel-group study in 132 healthy subjects . Anaesthesia was maintained with sevoflurane or propofol . At ~20 min following sevoflurane/propofol initiation , sugammadex 4 mg/kg or placebo was administered . Neuromuscular blocking agents were not administered . Electrocardiograms were recorded regularly . The primary variable was the time-matched mean difference in the Fridericia-corrected QT interval ( QTcF ) change from baseline for sugammadex versus placebo when combined with propofol or sevoflurane . No relevant QTcF prolongation was concluded if the upper one-sided 95 % confidence interval ( CI ) was below the 10 ms margin of regulatory non-inferiority , up to 30 min post- study drug . Blood sample s were taken for pharmacokinetic analysis . An exploratory analysis evaluated potential QT/QTc effects of neostigmine 50 μg/kg/glycopyrrolate 10 μg/kg in combination with propofol . Results The estimated mean QTcF differences between sugammadex and placebo ranged from −2.4 to 0.6 ms when combined with either anaesthetic . The largest upper one-sided 95 % CI for the mean QTcF difference  between sugammadex and placebo was 2 ms , occurring 2 min post-dosing . Propofol and sevoflurane result ed in mean QTcF increases exceeding 10 and 30 ms , respectively . On top of these prolongations , the effect of sugammadex was negligible at all timepoints . The mean peak su 
    Output:
    
R and omized controlled trials , in addition to a meta- analysis and a systematic review , have published results indicating faster and more consistent reversal of blockade while leading to fewer adverse events