title: Ideal versus corrected body weight for dosage of sugammadex in morbidly obese patients.
abstract: To date, the dosing of sugammadex is based on real body weight without taking fat content into account. We compared the reversal of profound rocuronium-induced neuromuscular blockade in morbidly obese patients using doses of sugammadex based on four different weight corrections. One hundred morbidly obese patients, scheduled for laparoscopic bariatric surgery under propofol-sufentanil anaesthesia, were randomly assigned four groups: ideal body weight; ideal body weight + 20%; ideal body weight + 40%; and real body weight. Patients received sugammadex 2 mg.kg(-1), when adductor pollicis monitoring showed two responses. The primary endpoint was full decurarisation. Secondary endpoints were the ability to get into bed independently on arrival to the post-anaesthetic care unit and clinical signs of residual paralysis. There was no residual paralysis in any patient. Morbidly obese patients can safely be decurarised from rocuronium-induced neuromuscular blockade T1-T2 with sugammadex dosed at 2 mg.kg(-1) ideal body weight + 40% (p < 0.0001).
authors.affiliation: Department of Anaesthesia, AZ Sint-Jan Brugge-Oostende AV, Belgium. philippe.vanlancker@azsintjan.be
authors.forename: P
authors.initials: P
authors.lastname: Van Lancker
authors.forename: B
authors.initials: B
authors.lastname: Dillemans
authors.forename: T
authors.initials: T
authors.lastname: Bogaert
authors.forename: J P
authors.initials: JP
authors.lastname: Mulier
authors.forename: M
authors.initials: M
authors.lastname: De Kock
authors.forename: M
authors.initials: M
authors.lastname: Haspeslagh
mesh_terms: D000328:Adult; D000732:Androstanols / Q000037:antagonists & inhibitors; D000762:Anesthesia Recovery Period; D050110:Bariatric Surgery / Q000379:methods; D001835:Body Weight / Q000502:physiology*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D003473:Neuromuscular Nondepolarizing Agents / Q000037:antagonists & inhibitors; D009767:Obesity, Morbid / Q000503:physiopathology / Q000601:surgery*; D000077123:Rocuronium; D000077122:Sugammadex; D055815:Young Adult; D047408:gamma-Cyclodextrins / Q000008:administration & dosage* / Q000494:pharmacology
chemical_list: D000732:Androstanols; D003473:Neuromuscular Nondepolarizing Agents; D047408:gamma-Cyclodextrins; D000077122:Sugammadex; D000077123:Rocuronium