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what is dose of sugammadex for deep reversal (zero twitches but with at least 1-2 post tetanic twitches)

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Final answer:

The recommended dose of sugammadex for deep neuromuscular blockade reversal, with zero twitches and one or two post-tetanic twitches, is 4 mg/kg.

Step-by-step explanation:

The dose of sugammadex for deep neuromuscular blockade reversal, characterized by zero twitches on a peripheral nerve stimulator but with the presence of one or two post-tetanic twitches, is typically 4 mg/kg. Sugammadex works by encapsulating and inactivating the steroidal neuromuscular blocking agents (like rocuronium or vecuronium) used during anesthesia, thereby reversing their effect. When a deeper level of reversal is required, as indicated by a lack of twitches with train-of-four (TOF) stimulation but some response to post-tetanic count (PTC), the recommended higher dose should provide prompt and reliable reversal of the neuromuscular blockade.

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