1. Bom A, Bradley M, Cameron K, Clark JK, Van Egmond J,
Feilden H, et al. A novel concept of reversing neuromuscular
block: chemical encapsulation of rocuronium bromide by
a cyclodextrin-based synthetichost. Angew Chem Int Ed Engl
2002;41:266-70.
2. Gijsenbergh F, Ramael S, Houwing N, van Iersel T. First human
exposure of Org 25969, a novel agent to reverse the action of rocuronium
bromide. Anesthesiology 2005;103:695-703. [CrossRef]
3. Sorgenfrei IF, Norrild K, Larsen PB, Stensballe J, Ostergaard D,
Prins ME, et al. Reversal of rocuronium-induced neuromuscular
block by the selective relaxant binding agent sugammadex: a
dose-finding and safety study. Anesthesiology 2006;104:667-74.
[CrossRef]
4. Bom A, Clark JK, Palin R. New approaches to reversal of neuromuscular
block. Curr Opin Drug Discov Devel 2002;5:793-800.
5. Baillard C, Clec’h C, Catineau J, Salhi F, Gehan G, Cupa M,
et al. Postoperative residual neuromuscular block: a survey of
management. Br J Anaesth 2005;95:622-6. [CrossRef]
7. European Medicines Agency. Available from: http://www.ema.
europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/000885/WC500052310.pdf.
8. Peplow PV. Effects of progesterone withdrawal on uterine prostaglandin
levels in the ovariectomized pregnant rat. Prostaglandins
Leukot Essent Fatty Acids 1991;44:259-61. [CrossRef]
9. Bennett JP, Vallance DK, Vickery BH. The synchronization
of ovulation in the adult female rat by oral administration of
megestrol acetate. J Reprod Fertil 1968;16:159-63. [CrossRef]
10. Mirakhur RK. Sugammadex in clinicalpractice. Anaesthesia
2009,64:45-54. [CrossRef]
11. Hogg RM, Mirakhur RK. Sugammadex a selective relaxant
binding agent for reversal of neuromuskuler block. Expert Rev
Neurother 2009;9:599-608. [CrossRef]
12. Rezonja K, Sostaric M, Vidmar G, Mars T. Dexamethasone
produces dose dependent inhibition of sugammadex reversal in
in vitro innervated primary human muscle ells. Anesth Analg
2014;118:755-63. [CrossRef]
13. Eikermann M, Zaremba S, Malhotra A, Jordan AS, Rosowand
C, Chamberlin NL. Neostigmine but not sugammadex impair
supper airway dilato rmuscle activity and breathing. Br J Anaesth
2008;101:344-9. [CrossRef]
14. Kalkan Y, Tumkaya L, Bostan H, Tomak Y, Yılmaz A. Effects
of sugammadex on immunoreactivity of calcineurin in rat testes
cell safter neuromuscular block: a pilot study. J Mol Histol
2011;9384-9.
15. Williamson RM, Mallaiah S, Barclav P. Rocuronium and sugammadex
for rapid seguence induction of obstetric general anaestheia.
Acta Anaesthesiol Scand 2011;55:644-99. [CrossRef]
16. Dao B. Vanage G, Li XJ, Bardin CW, Koide SS. Comparative effectiveness
of three antiprogestins aloneand in combination with
anordiol interminating pregnancy in the rat potent combination
was ORG 31806 plus anordiol. Contraception 1997;55:35-40.
[CrossRef]
17. Chwalisz K, Winter E, Thomas H. Robert TE. Synergistic role of
nitric oxide and progesterone during the establishment of pregnancy
in the rat. Human Reprod 1999;14:42-552. [CrossRef]
18. Elger W, Bartley J, Schneider B, Kaufmann G, Schubert G,
Chwalisz K. Endocrine pharmacological characterization of
progesterone antagonists and progesterone receptor modulators
with respect to PR-agonistic and antagonistic activity. Steroids
2000;65:713-23. [CrossRef]
19. Vodstrcil LA, Shynlova O, Westcott K, Simpson RLE, Wlodek
ME, et al. Progesterone withdrawal, and not increased circulating
relaxin, mediates the decrease in myometrial relaxin receptor
(RXFP1) expression in late gestation in rats. Biol Reprod
2010;83:825-32. [CrossRef]
20. Yang B, Zhou HJ, He QJ, Fang RY. Termination of early pregnancy
in the mouse, rat and hamster with DL111-IT and RU486.
Contraception 2000;62:211-6. [CrossRef]
21. Lv XH1, Shi da Z. Variations of serum estradiol and progesterone
levels during consecutive reproductive states in Mongolian
gerbils (Meriones unguiculatus). Exp Anim 2010;59:231-7.
[CrossRef]
22. Mete F, Kilic E, Somay A, Yilmaz B. Effects of heat stress on
endocrine functions&behaviour in the pre-pubertal rat. Indian J
Med Res 2012;135:233-9.
23. Kayashima K, Sozen R, Okura D. Insufficient sugammadex effect
in an obese pregnant woman undergoing cesarean section
under general anesthesia. Masui 2014;63:188-90.
24. Hamada K, Kayashima K. Management of cesarean section under
general anesthesia using sugammadex. Masui 2013;62:75-7.
25. Nauheimer D, Kollath C, Geldner G. Modified rapid sequence
induction for Caesarian sections: caseseries on theuse
of rocuronium and sugammadex. Anaesthesist 2012;61:691-5.
[CrossRef]
26. Shibusawa M, Ejima Y, Nishino R, Toyama H, Kurosawa S. Use
of sugammadex in patients undergoing caesarean section using
general anesthesia with rocuronium. Masui 2012;61:805-9.
The Effects of Sugammadex on Progesterone Levels in Pregnant Rats
Background: Sugammadex has been shown to decrease the efficiency of progesterone-containing oral contraceptive drugs which possess a steroid structure. Aims: The aim of the present study was to evaluate the effects of sugammadex on progesterone levels in pregnant rats as well as on the physiological course of the pregnancy. Study Design: Animal experiment. Methods: This study was approved by the Selçuk University Ethical Committee for Experimental Animal Research. Pregnant Winster Albino rats (n=26) were divided into three groups and administered with various intravenous injections on the 7th day of pregnancy. The control group (Group K, n=6) received 1.5 mL serum physiologic, the sugammadex group (Group S, n=10) received 30 mg/kg sugammadex and the sugammadex + rocuronium group (Group SR, n=10) received 30 mg/kg sugammadex and 3.5 mg/kg rocuronium. Progesterone levels were measured and the offspring were monitored for morphologic status. Results: Mean progesterone levels were 94.16±15.54 ng/mL in Group K, 87.86±12.48 ng/mL in Group S, and 94.53±16.10 ng/mL in Group SR (p>0.05). No stillbirth or miscarriage was observed in the rats. The mean number of offspring was 6.8±1.47 in Group K, 6.5±1.35 in Group S, and 6.4±1.17 in Group SR. The offspring appeared macroscopically normal. Conclusion: Sugammadex does not appear to affect the progesterone levels in pregnant rats in the first trimester and the clinical course. Successful completion of pregnancy and the absence of stillbirth or miscarriage will guide future studies about the use of sugammadex, particularly in the first trimester of the pregnancy.
1. Bom A, Bradley M, Cameron K, Clark JK, Van Egmond J,
Feilden H, et al. A novel concept of reversing neuromuscular
block: chemical encapsulation of rocuronium bromide by
a cyclodextrin-based synthetichost. Angew Chem Int Ed Engl
2002;41:266-70.
2. Gijsenbergh F, Ramael S, Houwing N, van Iersel T. First human
exposure of Org 25969, a novel agent to reverse the action of rocuronium
bromide. Anesthesiology 2005;103:695-703. [CrossRef]
3. Sorgenfrei IF, Norrild K, Larsen PB, Stensballe J, Ostergaard D,
Prins ME, et al. Reversal of rocuronium-induced neuromuscular
block by the selective relaxant binding agent sugammadex: a
dose-finding and safety study. Anesthesiology 2006;104:667-74.
[CrossRef]
4. Bom A, Clark JK, Palin R. New approaches to reversal of neuromuscular
block. Curr Opin Drug Discov Devel 2002;5:793-800.
5. Baillard C, Clec’h C, Catineau J, Salhi F, Gehan G, Cupa M,
et al. Postoperative residual neuromuscular block: a survey of
management. Br J Anaesth 2005;95:622-6. [CrossRef]
7. European Medicines Agency. Available from: http://www.ema.
europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/000885/WC500052310.pdf.
8. Peplow PV. Effects of progesterone withdrawal on uterine prostaglandin
levels in the ovariectomized pregnant rat. Prostaglandins
Leukot Essent Fatty Acids 1991;44:259-61. [CrossRef]
9. Bennett JP, Vallance DK, Vickery BH. The synchronization
of ovulation in the adult female rat by oral administration of
megestrol acetate. J Reprod Fertil 1968;16:159-63. [CrossRef]
10. Mirakhur RK. Sugammadex in clinicalpractice. Anaesthesia
2009,64:45-54. [CrossRef]
11. Hogg RM, Mirakhur RK. Sugammadex a selective relaxant
binding agent for reversal of neuromuskuler block. Expert Rev
Neurother 2009;9:599-608. [CrossRef]
12. Rezonja K, Sostaric M, Vidmar G, Mars T. Dexamethasone
produces dose dependent inhibition of sugammadex reversal in
in vitro innervated primary human muscle ells. Anesth Analg
2014;118:755-63. [CrossRef]
13. Eikermann M, Zaremba S, Malhotra A, Jordan AS, Rosowand
C, Chamberlin NL. Neostigmine but not sugammadex impair
supper airway dilato rmuscle activity and breathing. Br J Anaesth
2008;101:344-9. [CrossRef]
14. Kalkan Y, Tumkaya L, Bostan H, Tomak Y, Yılmaz A. Effects
of sugammadex on immunoreactivity of calcineurin in rat testes
cell safter neuromuscular block: a pilot study. J Mol Histol
2011;9384-9.
15. Williamson RM, Mallaiah S, Barclav P. Rocuronium and sugammadex
for rapid seguence induction of obstetric general anaestheia.
Acta Anaesthesiol Scand 2011;55:644-99. [CrossRef]
16. Dao B. Vanage G, Li XJ, Bardin CW, Koide SS. Comparative effectiveness
of three antiprogestins aloneand in combination with
anordiol interminating pregnancy in the rat potent combination
was ORG 31806 plus anordiol. Contraception 1997;55:35-40.
[CrossRef]
17. Chwalisz K, Winter E, Thomas H. Robert TE. Synergistic role of
nitric oxide and progesterone during the establishment of pregnancy
in the rat. Human Reprod 1999;14:42-552. [CrossRef]
18. Elger W, Bartley J, Schneider B, Kaufmann G, Schubert G,
Chwalisz K. Endocrine pharmacological characterization of
progesterone antagonists and progesterone receptor modulators
with respect to PR-agonistic and antagonistic activity. Steroids
2000;65:713-23. [CrossRef]
19. Vodstrcil LA, Shynlova O, Westcott K, Simpson RLE, Wlodek
ME, et al. Progesterone withdrawal, and not increased circulating
relaxin, mediates the decrease in myometrial relaxin receptor
(RXFP1) expression in late gestation in rats. Biol Reprod
2010;83:825-32. [CrossRef]
20. Yang B, Zhou HJ, He QJ, Fang RY. Termination of early pregnancy
in the mouse, rat and hamster with DL111-IT and RU486.
Contraception 2000;62:211-6. [CrossRef]
21. Lv XH1, Shi da Z. Variations of serum estradiol and progesterone
levels during consecutive reproductive states in Mongolian
gerbils (Meriones unguiculatus). Exp Anim 2010;59:231-7.
[CrossRef]
22. Mete F, Kilic E, Somay A, Yilmaz B. Effects of heat stress on
endocrine functions&behaviour in the pre-pubertal rat. Indian J
Med Res 2012;135:233-9.
23. Kayashima K, Sozen R, Okura D. Insufficient sugammadex effect
in an obese pregnant woman undergoing cesarean section
under general anesthesia. Masui 2014;63:188-90.
24. Hamada K, Kayashima K. Management of cesarean section under
general anesthesia using sugammadex. Masui 2013;62:75-7.
25. Nauheimer D, Kollath C, Geldner G. Modified rapid sequence
induction for Caesarian sections: caseseries on theuse
of rocuronium and sugammadex. Anaesthesist 2012;61:691-5.
[CrossRef]
26. Shibusawa M, Ejima Y, Nishino R, Toyama H, Kurosawa S. Use
of sugammadex in patients undergoing caesarean section using
general anesthesia with rocuronium. Masui 2012;61:805-9.
Et, T., Topal, A., Erol, A., Tavlan, A., vd. (2015). The Effects of Sugammadex on Progesterone Levels in Pregnant Rats. Balkan Medical Journal, 32(2), 203-207.
AMA
Et T, Topal A, Erol A, Tavlan A, Kılıçaslan A, Uzun ST. The Effects of Sugammadex on Progesterone Levels in Pregnant Rats. Balkan Medical Journal. Nisan 2015;32(2):203-207.
Chicago
Et, Tayfun, Ahmet Topal, Atilla Erol, Aybars Tavlan, Alper Kılıçaslan, ve Sema Tuncer Uzun. “The Effects of Sugammadex on Progesterone Levels in Pregnant Rats”. Balkan Medical Journal 32, sy. 2 (Nisan 2015): 203-7.
EndNote
Et T, Topal A, Erol A, Tavlan A, Kılıçaslan A, Uzun ST (01 Nisan 2015) The Effects of Sugammadex on Progesterone Levels in Pregnant Rats. Balkan Medical Journal 32 2 203–207.
IEEE
T. Et, A. Topal, A. Erol, A. Tavlan, A. Kılıçaslan, ve S. . T. Uzun, “The Effects of Sugammadex on Progesterone Levels in Pregnant Rats”, Balkan Medical Journal, c. 32, sy. 2, ss. 203–207, 2015.
ISNAD
Et, Tayfun vd. “The Effects of Sugammadex on Progesterone Levels in Pregnant Rats”. Balkan Medical Journal 32/2 (Nisan 2015), 203-207.
JAMA
Et T, Topal A, Erol A, Tavlan A, Kılıçaslan A, Uzun ST. The Effects of Sugammadex on Progesterone Levels in Pregnant Rats. Balkan Medical Journal. 2015;32:203–207.
MLA
Et, Tayfun vd. “The Effects of Sugammadex on Progesterone Levels in Pregnant Rats”. Balkan Medical Journal, c. 32, sy. 2, 2015, ss. 203-7.
Vancouver
Et T, Topal A, Erol A, Tavlan A, Kılıçaslan A, Uzun ST. The Effects of Sugammadex on Progesterone Levels in Pregnant Rats. Balkan Medical Journal. 2015;32(2):203-7.