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Review question / Objective: To conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) to compare the effect of lower-dose sugammadex using IBW or CBW as dosing scalars, with that of standard-dose sugammadex based on TBW, on reversal time, defined as time to recovery of train of four ratio (TOFR) ≥ 0.9, among morbidly obese people after moderate or deep NMB with either rocuronium or vecuronium. Eligibility criteria: We included only randomized controlled trials (RCTs) that compared TBW with other dosing scalars for sugammadex. Studies not published in full text articles or in languages other than English were excluded. Trials that included patients above 18 years of age and BMI more than or equal to 40 who underwent general anaesthesia with any degree of NMB induced by either rocuronium or vecuronium. Trials that evaluated TBW and other dosing scalars for sugammadex were included. We included trials that compared TBW with any other dosing scalars for sugammadex. Trials that did not include dosing based on TBW as one arm in the comparison were excluded.

Appropriate dosing of sugammadex for reversal of rocuronium-/vecuronium-induced muscle relaxation in morbidly obese patients: a meta-analysis of randomized controlled trials