Summary Sugammadex is a novel reversal agent for aminosteroid neuromuscular blocking drugs, especially rocuronium. Given its renal excretion, sugammadex is not recommended for patients with end‐stage renal disease; however, reports exist of its use in this group of patients. This two‐institutional retrospective observational study aimed to review the safety profile and effectiveness of sugammadex in surgical patients with end‐stage renal disease who required pre‐operative renal replacement therapy. Adult surgical patients with end‐stage renal disease requiring pre‐operative renal replacement therapy, who received sugammadex between April 2016 and January 2019, were studied. The primary outcome was the incidence of postoperative tracheal re‐intubation within 48 h. The secondary outcome was the incidence of deferred tracheal extubation in the operating theatre. One hundred and fifty‐eight patients were identified from 125,653 surgical patients: 48 patients (30%) underwent renal transplantation and 110 (70%) underwent non‐renal transplantation procedures. There were 22 instances (14%) of deferred tracheal extubation due to surgical and/or pre‐existing medical conditions. Out of the 136 patients who had the tracheal tube removed at the end of the procedure, three patients had their trachea re‐intubated within 48 h: two patients developed pulmonary oedema resulting from volume overload; and one patient had worsening sepsis. No incidence of recurrence of neuromuscular blockade was observed. Of note, 24 (18%) patients were found to have incomplete neuromuscular blockade reversal with neostigmine but administration of sugammadex led to successful tracheal extubation. In conclusion, sugammadex appears to be safe and effective in adult patients with end‐stage renal disease receiving pre‐operative renal replacement therapy.

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This information will assist surgeons in accepting or rejecting grafts based on the epidemiology of the distal tibial morphology as it relates to glenoid augmentation.

Failure and complication rates in the early postoperative period using a unicortical suture button for biceps tenodesis fixation are consistent with other reported techniques. This study adds clinical data to the existing biomechanical reports that this technique is strong enough to provide stable fixation of the biceps tendon to allow healing of the tendon to the humerus.

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