Sugammadex in Colorectal and da Vinci Surgery

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Traditionally, reversal of neuromuscular blocking agents following the completion of surgery was achieved with cholinesterase inhibitors. Recently, sugammadex has been increasingly relied upon. Sugammadex is a γ-cyclodextrin molecule that rapidly reverses steroidal neuromuscular blocking drugs. Its use following colorectal surgery has become more common, and while the rapidity of reversal is undoubtedly improved, whether sugammadex impacts clinical postoperative outcomes is unknown. This systematic review and meta-analysis aims to compare postoperative outcomes in patients receiving sugammadex to those receiving a control during colorectal surgery. [1]

In 2000, the da Vinci Surgery System was approved by the FDA for general laparoscopic surgery and it became the first commercially available robotic surgery system. The aim of this study was to identify the incidence of postoperative pulmonary complications (PPCs) in patients undergoing da Vinci surgery and to observe whether the incidence of PPCs was affected by the usage of Sugammadex. While the overall incidence of PPCs was 30.3% (101/333 patients), the incidence of PCC in patients who received Sugammadex (24.2%) was significantly lower than those without (37.3%) (p = 0.001). [2]

While in case of colorectal surgery there was no significant improvement in the risk of adverse respiratory events on the account of Sugammadex application, the use of Sugammadex decreased the risk of PPC in da Vinci surgery.

[1] Andrew T. Chen, Ashaka Patel, Tyler McKechnie, Aristithes G. Doumouras, Dennis Hong,
Cagla Eskicioglu (2022) Sugammadex in Colorectal Surgery: A Systematic Review and Meta-analysis. JSR Surgical Research 270, 221-229.

[2] Cheng, Kuang-I., Jockey Tse, and Tzu-Ying Li. (2022) The Strategy to Use Sugammadex to Reduce Postoperative Pulmonary Complications after da Vinci Surgery: A Retrospective Study. Journal of Personalized Medicine 12, 52.

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