Sugammadex administration in pregnant patients undergoing non-obstetric surgery: a case series.

The use of sugammadex for reversal of rocuronium-induced neuromuscular blockade after caesarean section is nowadays common practice, but concerns exist about its use in pregnant women undergoing non-obstetric surgery. We report six cases of pregnant women submitted to general anesthesia for non-obstetric surgery in which neuromuscular blockade was reversed with sugammadex. We followed the outcome of both mother and baby during and after delivery. Sugammadex seemed to be a safe option for both mother and baby but more reports are necessary to fill the evidence gap and increase the global knowledge about its safety in this special group of patients.

Sugammadex reduces postoperative pain after laparoscopic bariatric surgery: a randomized trial.

BACKGROUND: Morbid obese (MO) population is increasing every year worldwide, and laparoscopic bariatric surgery (LBS) has a central role in their treatment. The postoperative period of MO is not free from complications. The introduction of sugammadex has brought huge developments in patient's safety and nowadays LBS is performed with better care and quality. However, the effect of this agent in postoperative pain is still unknown. MATERIALS AND METHODS: A controlled trial enrolling 88 MO submitted to LBS under general anesthesia using muscle relaxation, randomly assigned into 2 groups: one received sugammadex (SUG group) at the end of surgery and the other neostigmine (NEO group). In the postanesthetic care unit (PACU), we evaluated pain using the visual analogue scale in 4 different moments: arrival in the PACU, 30 minutes after arrival, 60 minutes after arrival, and immediately before leaving the PACU. We also recorded the presence of postoperative nausea and vomits (PONV) and the duration of the PACU stay before discharge to the ward. RESULTS: Forty-four patients received sugammadex and 44 received neostigmine. We found lower visual analogue scale pain scores in the SUG group at 30 and 60 minutes after arriving to the PACU (P<0.05). We also had less PONV in the SUG group and these patients were also discharged earlier. CONCLUSIONS: Sugammadex is associated with less pain felt in the PACU. This "opioid-sparing" effect, combined with less PONV and a faster discharge from the PACU, makes sugammadex an indispensable drug in this type of patients and allows fast-track surgery in the MO.