A meta-analysis has been recently published about the dosing of sugammadex (SGM) for neuromuscular blockade (NMB) induced muscle relaxation in morbidly obese patients.
Several databases were searched for randomized controlled trials (RCTs) comparing lower-dose sugammadex (SGM) using ideal body weight (IBW) or corrected body weight (CBW) as dosing scalars with standard-dose sugammadex based on total body weight (TBW) among morbidly obese people after NMB.
Overall, 444 morbidly obese patients were included in the analysis that included five RCTs.
In conclusion, lower-dose SGM based on ideal body weight had a reversal time 56 s longer than standard-dose sugammadex based on total body weight among patients with morbid obesity that received rocuronium- or vecuronium-induced NMB (mean difference 55.77 s, 95% confidence interval [CI] 32.01, 79.53 s). Conversely, lower-dose sugammadex based on corrected body weight (calculated as IBW + 0.4 × [TBW–IBW]) had a similar reversal time as standard-dose SGM based on TBW among patients with morbid obesity (mean difference 2.28 s, 95% CI –10.34, 14.89 s).
Jian-Qiang Liao et al, Appropriate dosing of sugammadex for reversal of rocuronium-/vecuronium-induced muscle relaxation in morbidly obese patients: a meta-analysis of randomized controlled trials, J Int Med Res, 2022, 50(8)