Date of Award

Fall 2019

Degree Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)


Leadership and Advanced Nursing Practice

Committee Chair

Michong Rayborn

Committee Chair School

Leadership and Advanced Nursing Practice

Committee Member 2

Nina McLain

Committee Member 2 School

Leadership and Advanced Nursing Practice


As healthcare costs in the United States continue to rise, healthcare providers must do their part to negate the expenses incurred by hospitals and patients. However, some treatments or medications may be more beneficial than others but come at a higher price. Such is the case with sugammadex, a medication approved for use in 2015 that can effectively and reliably reverse paralysis brought about by aminosteroidal induced neuromuscular blockade with rocuronium. Neostigmine/robinul combinations have traditionally been used for neuromuscular blockade reversal but with less efficient results than sugammadex (Abad-Gurumeta et al., 2015). Hence, a cost analysis was conducted at a facility in North Mississippi with a 9-bed operating room to compare the price difference between these two methods of reversing neuromuscular blockade. After prices for each medication were retrieved from the facility, a mean number of cases requiring neuromuscular blockade for surgery was calculated per month. The cost of sugammadex was applied to the average case number and then added over a 6-month period. The same was also done for the neostigmine/robinul combination. The calculation resulted in sugammadex totaling $63,416.64 over six months and neostigmine/robinul combination totaling $12,485.76 over six months. A difference of $50,930.88, which results in 80.3% cost-savings, was noted between the two reversal methods in favor of neostigmine/robinul. The results were shared with anesthesia providers at the facility along with an extensive literature review describing the benefits and complications of both sugammadex and neostigimine/robinul.