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The Efficacy and Adverse Effects of Sugammadex and Neostigmine in Reversing Neuromuscular Blockade Inpatients with Obesity Undergoing Metabolic and Bariatric Surgery: A Systematic Review with Meta-Analysis and Trial Sequential Analysis.
Medicina (Kaunas)
November 2024
Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu 610041, China.
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.*
Comparison of Postoperative Muscle Strength Recovery Between Cisatracurium and Rocuronium.
Cureus
August 2024
Department of Radiology, Shri B M Patil Medical College Hospital and Research Centre, Bijapur Lingayat District Educational University, Vijayapura, IND.
Background Neuromuscular blocking agents are crucial for anesthesia but can cause reversible paralysis, leading to risks like postoperative residual dysfunction. Undetected paralysis in the post-anesthesia care unit (PACU) jeopardizes patient safety by impairing airway function and increasing complications. Effective reversal, assessed clinically or via nerve stimulation, is critical to prevent residual postoperative curarization (RPOC), which is linked to significant morbidity and mortality.
View Article and Find Full Text PDFDiaphragm ultrasonography as a monitor in assessing antagonistic effect of sugammadex on rocuronium in patients with Child-Pugh grades A and B.
Front Med (Lausanne)
April 2024
Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Background: Although diaphragm ultrasound can be used for detecting residual neuromuscular blockade post-surgery, there exists notable dearth in contemporary research exploring the correlation between preoperative Child-Pugh classification and the effectiveness of sugammadex in reversing rocuronium-induced blockade as evaluated by diaphragmatic ultrasonography.
Methods: This was a prospective, double-blind, non-randomized controlled clinical trial conducted on patients scheduled for laparoscopic liver resection surgery. The participants were categorized into two groups, A and B, based on their preoperative Child-Pugh classification.
Comparison of Different Weight Scalars to Dose Sugammadex for the Reversal of Neuromuscular Blockade in Morbidly Obese Patients: A Systematic Review.
Cureus
March 2024
Anesthesiology and Perioperative Medicine, London Health Sciences Centre, Western University, London, CAN.
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).
View Article and Find Full Text PDFCoadministration of intravenous calcium along with neostigmine for rapid neuromuscular blockade recovery: A systematic review and meta-analysis.
J Anaesthesiol Clin Pharmacol
April 2023
Department of Anesthesiology and Critical Care, AIIMS, Bhubaneswar, Odisha, India.
Postoperative residual curarization (PORC) and the impact of the coadministration of intravenous calcium along with an acetylcholinesterase inhibitor on it are not well addressed. Extensive electronic database screening was done until October 7, 2022 after enlisting the protocol of this systematic review in PROSPERO (CRD42021274879). Randomized controlled trials (RCTs) evaluating the impact of intravenous calcium and neostigmine coadministration on neuromuscular recovery were included in this meta-analysis.
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