%0 Journal Article
%T Sugammadex and Ideal Body Weight in Bariatric Surgery
%A Maria Sanfilippo
%A Francesco Alessandri
%A Ahmed Abdelgawwad Wefki Abdelgawwad Shousha
%A Antonio Sabba
%A Alessandra Cutolo
%J Anesthesiology Research and Practice
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/389782
%X Background. The obese patients have differences in body composition, drug distribution, and metabolism. Sugammadex at 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£¿¦Ìg£¿kg£¿1, propofol 3£¿mg£¿kg£¿1, rocuronium 0,6£¿mg£¿kg£¿1, oxygen, air, and desflurane (6¨C8%). Maintenance doses of rocuronium were 1/4 of the intubation dose. Sugammadex was administrated at recovery. Results. The durations of intubation and maintenance doses of rocuronium were similar in both groups. In IBW group, the / value of 0.9 was reached in 151£¿¡À£¿44 seconds and in 121£¿¡À£¿55 seconds in RBW group ( ). Discussion. Recovery times to / 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. 1. Introduction Sugammadex, a modified ¦Ã-cyclodextrin, has been recently introduced into clinical practice as a selective relaxant binding agent for antagonism of prolonged rocuronium-induced neuromuscular block during general anaesthesia. Sugammadex forms a complex with the neuromuscular blocking agents (NMBAs) rocuronium or vecuronium. By forming complexes with these NMBAs, it reduces their ability to bind to nicotinic receptors at the neuromuscular junction. Upon injection of Sugammadex, any rocuronium or vecuronium molecules present in the plasma and at their sites of action are attracted to Sugammadex via lipophilic binds in a ratio of one Sugammadex molecule to one molecule of the NMBA [1¨C4]. This causes a concentration gradient and any remaining rocuronium or vecuronium molecules are attracted back into the plasma and become bound to free Sugammadex molecules [2, 3]. At recovery of train-of-four (TOF) Sugammadex can completely reverse the neuromuscular block in a dose of 2£¿mg£¿kg£¿1 of real body weight (RBW). Obesity does not affect the efficacy of Sugammadex in reversing rocuronium-induced neuromuscular block [5], but the majority of authors and the literature recommend Sugammadex dose to be calculated upon RBW. As the obese patients have a different drug
%U http://www.hindawi.com/journals/arp/2013/389782/