Obesity Surgery

, Volume 23, Issue 10, pp 1558–1563

Sugammadex Allows Fast-Track Bariatric Surgery

  • Michele Carron
  • Stefano Veronese
  • Mirto Foletto
  • Carlo Ori
Original Contributions

DOI: 10.1007/s11695-013-0926-y

Cite this article as:
Carron, M., Veronese, S., Foletto, M. et al. OBES SURG (2013) 23: 1558. doi:10.1007/s11695-013-0926-y

Abstract

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

Keywords

Morbidly obese patient Adjustable gastric banding Fast-track surgery Neuromuscular blockade Sugammadex 

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Michele Carron
    • 1
  • Stefano Veronese
    • 1
  • Mirto Foletto
    • 2
  • Carlo Ori
    • 1
  1. 1.Department of Medicine, Anesthesiology and Intensive CareUniversity of PadovaPaduaItaly
  2. 2.Bariatric UnitUniversity of PadovaPaduaItaly

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