Key result
Sugammadex dosed at 2 mg/kg of ideal body weight resulted in a similar time to reach a T4/T1 ratio of 0.9 compared to real body weight dosing (151 ± 44 vs 121 ± 55 seconds; P=0.07).
Why the study?
Does Sugammadex dosed by ideal body weight compared to real body weight provide safe and rapid recovery of neuromuscular block in patients undergoing bariatric surgery?
RCT (n=40)
Does Sugammadex dosed by ideal body weight compared to real body weight provide safe and rapid recovery of neuromuscular block in patients undergoing bariatric surgery?
Absolute Event Rate: 151% vs 121%
p-value: p=0.07
Sugammadex dosed by ideal body weight provides similar recovery times to real body weight dosing in bariatric surgery patients, without postoperative residual curarization.
May support ideal body weight dosing to limit exposure in bariatric patients; leaves open need for randomized confirmation of equivalence.
Background. The obese patients have differences in body composition, drug distribution, and metabolism. Sugammadex at T 2 recovery in a dose of 2 mg kg(-1) of real body weight (RBW) can completely reverse the NMB block; in our study we investigated the safety and efficacy of Sugammadex dose based on their ideal body weight (IBW). Methods. 40 patients of both sexes undergoing laparoscopic bariatric surgery were enrolled divided into 2 groups according to the dose of Sugammadex: the first received a dose of 2 mg kg(-1) of IBW and the second received a dose of 2 mg kg(-1) of RBW. Both were anesthetized with doses calculated according to the IBW: fentanyl 2 μ g kg(-1), propofol 3 mg kg(-1), rocuronium 0,6 mg kg(-1), oxygen, air, and desflurane (6-8%). Maintenance doses of rocuronium were 1/4 of the intubation dose. Sugammadex was administrated at T 2 recovery. Results. The durations of intubation and maintenance doses of rocuronium were similar in both groups. In IBW group, the T 4/T 1 value of 0.9 was reached in 151 ± 44 seconds and in 121 ± 55 seconds in RBW group (P = 0.07). Discussion. Recovery times to T 4/T 1 of 0.9 are surprisingly similar in both groups without observing any postoperative residual curarization. Conclusion. Sugammadex doses calculated according to the IBW are certainly safe for a rapid recovery and absence of PORC.
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Sanfilippo et al. (2013) conducted an RCT in Obesity requiring laparoscopic bariatric surgery (n=40). Sugammadex vs. Sugammadex 2 mg kg(-1) of real body weight (RBW) was evaluated on Time to reach T4/T1 value of 0.9 (seconds) (p=0.07). Sugammadex dosed at 2 mg/kg of ideal body weight resulted in a similar time to reach a T4/T1 ratio of 0.9 compared to real body weight dosing (151 ± 44 vs 121 ± 55 seconds; P=0.07).
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