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Table 1 Recommended dose of sugammadex by reliable sources

From: Residual paralysis caused by 50 mg rocuronium after reversal with 4 mg/kg sugammadex: a case report

Source Description
Manufacturer’s instructions [1] 4 mg/kg is recommended if spontaneous recovery of the twitch response has reached 1–2 PTCs and there are no twitch responses to TOF stimulation.
2 mg/kg is recommended if spontaneous recovery has reached the reappearance of the second twitch in response to TOF stimulation.
Miller’s anesthesia textbook [2] Three different doses of sugammadex are recommended according to the level of block. A large dose (16 mg/kg) is given during intense block (no response to PTC stimulation), a medium dose (4 mg/kg) during deep block (two or more responses to PTC), and a low dose (2 mg/kg) during moderate block (two or more responses to TOF stimulation).
Review article [3] For reversal of moderate block (TOF count, 1–3), a dose of 2 mg/kg is recommended; for reversal of deep block (PTC ≥ 1), a dose of 4 mg/kg is recommended.
Online resource [4] Deep block (at least 1–2 post-tetanic counts and prior to the second twitch following TOF stimulation): 4 mg/kg as a single dose. Moderate block (after appearance of the second twitch following TOF stimulation): 2 mg/kg as a single dose.
  1. PTC Post-tetanic count, TOF Train-of-four