Sugammadex and Ideal Body Weight in Bariatric Surgery

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.