Ideal versus corrected body weight for dosage of sugammadex in morbidly obese patients

Abstract

SummaryTo 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 propofolsufentanil 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

Residual curarization and postoperative respiratory complications following laparoscopic sleeve gastrectomy. The effect of reversal agents: sugammadex vs. neostigmine

“…Similar uncertainty remains regarding the ideal dosing of sugammadex, which would prevent residual curarization. While some studies [14] recommend dosing sugammadex at 2 mg.kg -1 total body weight if two twitches are present in the TOF count, Van Lanke [15] found that the appropriate dose should be calculated on the basis of ideal body weight according to the formula "Ideal body weight plus 40% of the excess weight". This means that though some of our patients were suboptimally dosed on a total body weight basis, they still received enough sugammadex according to Van Lanker's recommended dosage.…”

Perioperative management of the severely obese patient: a selective pathophysiological review

“…Data are available to provide some guidance on appropriate dosing for common perioperative medications (Table 3). 64,65,[67][68][69][70][71][72][73][74] In Table 4, there is an outline of the calculation methods for the various dosing weights.…”

“…20%, ideal body weight ? 40%, and actual body weight (69). The time from administration of sugammadex to TOF ratio [ 90% was shortest in the IBW ?…”

Sugammadex: An Update

“…Most authors recommend rocuronium dosing by ideal body weight and sugammadex dosing by IBW + 40% [21].…”