Sugammadex in pregnant women

An open-labelled plasma pharmacokinetic study examining the pharmacokinetics of a single bolus intravenous (IV) dose of sugammadex in women undergoing elective caesarean section under general anaesthesia at the Royal Brisbane and Women’s Hospital (RBWH). We will also determine the amount excreted in breastmilk. Dosing of sugammadex will be as per manufacturers instructions and determined by train-of four assessment. At the completion of surgery, sugammadex will be administered for reversal at doses determined by the depth of neuromuscular block and according to the product information: 2 mg kg-1 for moderate neuromuscular block (defined by the appearance of two twitches on train of four) and 4 mg kg-1 for deep neuromuscular block (defined as the appearance of two twitches with post-tetanic count) dosed for total body weight. Following administration of sugammadex, a train of four ratio (TOFR) will be performed at 20 second intervals until a TOFR of >0.9 is observed. Sugammadex will be administered at the completion of surgery as per standard practice. A dedicated research nurse who will be present to facilitate sampling and to answer questions about the research and monitor adherence to the intervention.