Comparison of Different Weight Scalars to Dose Sugammadex for the Reversal of Neuromuscular Blockade in Morbidly Obese Patients: A Systematic Review

Yamini Subramani; Manikandan Rajarathinam; Anita Dabirzadeh; Qutaiba Tawfic; Sarah Krause; Yasin Avci; Mahesh Nagappa

doi:10.7759/cureus.57057

Comparison of Different Weight Scalars to Dose Sugammadex for the Reversal of Neuromuscular Blockade in Morbidly Obese Patients: A Systematic Review

Cureus. 2024 Mar 27;16(3):e57057. doi: 10.7759/cureus.57057. eCollection 2024 Mar.

Authors

Yamini Subramani¹, Manikandan Rajarathinam², Anita Dabirzadeh², Qutaiba Tawfic², Sarah Krause³, Yasin Avci⁴, Mahesh Nagappa²

Affiliations

¹ Anesthesiology and Perioperative Medicine, London Health Sciences Centre, Western University, London, Canada.
² Anesthesiology and Perioperative Medicine, London Health Sciences Centre, Western University, London, CAN.
³ Medical Sciences, Western University, London, CAN.
⁴ Interdisciplinary Arts and Science, Western University, London, CAN.

Abstract

This systematic review was conducted to evaluate the optimal weight scalar to dose sugammadex in a morbidly obese (MO) patient population (BMI≥40 kg/m²). 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). Eight randomized controlled trials (RCTs) involving 645 participants were included. The different dose scalars included were total body weight (TBW), ideal body weight (IBW), 20% corrected body weight (CBW) and 40% CBW). A dose of 2 mg/kg of sugammadex based on 40% CBW and a 4 mg/kg dose of sugammadex based on 40% CBW provide a reliable and timely reversal of moderate and deep NMB respectively in the MO patients.

Keywords: neuromuscular blockade; obesity; overweight; reversal; sugammadex.

Publication types

Review