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http://dx.doi.org/10.1007/s12630-011-9651-yDOI Listing

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Article Synopsis
  • Metabolic and bariatric surgery (MBS) is used globally, and this study explores the benefits of sugammadex in reversing neuromuscular blockade (NMB) for obese patients undergoing the procedure, comparing it to neostigmine.*
  • The systematic review analyzed data from nine studies involving 633 patients, finding that sugammadex led to significantly quicker recovery times and reduced risks of postoperative complications like residual curarization, nausea, vomiting, and cardiovascular issues.*
  • The findings suggest that sugammadex is a more effective and safer option than neostigmine for managing NMB in obese patients during bariatric surgeries.*
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The prevalence of morbid obesity in today's population around the world is alarming. Morbid obesity involves substantial changes in body composition and function, which can affect the pharmacodynamics and pharmacokinetics of many drugs. This paper aims to discuss the application of muscle relaxants and their reversing agents in patients with morbid obesity.

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Background: Residual neuromuscular blockade can be associated with serious postoperative complications. Sugammadex is a newer neuromuscular blocking drug (NMBD) reversal agent that rapidly and completely reverses rocuronium. Whether sugammadex has any advantages over neostigmine in morbidly obese patients with obstructive sleep apnea (OSA) is unclear.

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This systematic review was conducted to evaluate the optimal weight scalar to dose sugammadex in a morbidly obese (MO) patient population (BMI≥40 kg/m). The primary outcome was recovery time from moderate neuromuscular blockade (NMB) or deep NMB. Secondary outcomes included time to extubation and incidence of postoperative residual curarization (PORC).

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Article Synopsis
  • * An 84-year-old patient experienced pulseless electrical activity post-surgery even after sugammadex seemed to successfully reverse the neuromuscular block.
  • * The case emphasizes the need for careful monitoring and dosing of sugammadex, especially in elderly, obese, or compromised patients, to avoid potential complications like recurarization.
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