Reversal of neuromuscular block

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Reversal of neuromuscular block A. Srivastava, J.M. Hunter British Journal of Anaesthesia Volume 103, Issue 1, Pages 115-129 (July 2009) DOI: 10.1093/bja/aep093 Copyright © 2009 British Journal of Anaesthesia Terms and Conditions

Fig 1 Structure of sugammadex showing eight glucopyranoside units linked together via α 1→4 linkages to maintain a doughnut-like shape. Reproduced with permission.121 British Journal of Anaesthesia 2009 103, 115-129DOI: (10.1093/bja/aep093) Copyright © 2009 British Journal of Anaesthesia Terms and Conditions

Fig 2 Structural arrangements of glucopyranose units in a γ-cyclodextrin, showing negatively charged hydroxyl groups at the rims creating the primary and secondary faces. Reproduced with permission.121 British Journal of Anaesthesia 2009 103, 115-129DOI: (10.1093/bja/aep093) Copyright © 2009 British Journal of Anaesthesia Terms and Conditions

Fig 3 The encapsulation process: sugammadex carboxyl groups interact with the steroidal rings A, B, C, and D of the aminosteroid NMBA molecule drawing it into the cavity of the cyclodextrin where additional non-covalent attractions (⇔) hold the molecule securely in place. Reproduced with permission.122 British Journal of Anaesthesia 2009 103, 115-129DOI: (10.1093/bja/aep093) Copyright © 2009 British Journal of Anaesthesia Terms and Conditions