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Sugammadex Allows Fast-Track Bariatric Surgery.
MedLine Citation:
PMID:  23519634     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Morbidly obese (MO) patients are at increased risk for postoperative anesthesia-related complications. We evaluated the role of sugammadex versus neostigmine in the quality of recovery from profound rocuronium-induced neuromuscular blockade (NMB) in patients with morbid obesity. METHODS: We studied 40 female MO patients who received desflurane and remifentanil anesthesia for laparoscopic removal of adjustable gastric banding. NMB was achieved with rocuronium. At the end of the surgical procedure, complete reversal of NMB was obtained with sugammadex (SUG group, n = 20) or neostigmine plus atropine (NEO group, n = 20) in the presence of profound NMB. RESULTS: No difference in surgical time or anesthetic drugs was found between the groups. Anesthesia time was significantly greater in the NEO group than in the SUG group (95 ± 21 vs. 47.9 ± 6.4 min, p < 0.0001), which was mainly due to a longer time to reach a train-of-four ratio (TOFR) ≥ 0.9 in the NEO group (48.6 ± 18 vs. 3.1 ± 1.3 min, p < 0.0001) during reversal of profound NMB. Upon admission to the postanesthesia care unit, level of SpO2 (p = 0.018), TOFR (p < 0.0001), ability to swallow (p = 0.0027), and ability to get into bed independently (p = 0.022) were better in the SUG group than in the NEO group. Patients in the SUG group were discharged to the surgical ward earlier than patients in the NEO group were (p = 0.013). CONCLUSIONS: Sugammadex allowed a safer and faster recovery from profound rocuronium-induced NMB than neostigmine did in patients with MO. Sugammadex may play an important role in fast-track bariatric anesthesia.
Authors:
Michele Carron; Stefano Veronese; Mirto Foletto; Carlo Ori
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-3-22
Journal Detail:
Title:  Obesity surgery     Volume:  -     ISSN:  1708-0428     ISO Abbreviation:  Obes Surg     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-3-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9106714     Medline TA:  Obes Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Medicine, Anesthesiology and Intensive Care, University of Padova, Via C. Battisti, 267-35121, Padua, Italy, micarron@libero.it.
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