Comparative Study Between Neostigmine Versus Sugammadex in Obese Patients Undergoing Laparoscopic Surgery

Abstract

omplete and rapid reversal of the effects of neuromuscular blocker drugs is a primary element of safety in anaesthesia. Neuromuscular conduction that is not completely improved leads to post-operative residual curarisation and the development of complications that are related to respiration. The use of neostigmine, which is a cholinesterase inhibitor, is a standard procedure for the reversal of the effect of neuromuscular blockers, but some side effects, such as slowed heart rate, increased secretion and bronchospasm, make its use more difficult. In contrast, anti-cholinergic drugs, including atropine and glycopyrrolate, which are used for preventing these side effects, increase the frequency of arrhythmia and cause blurred vision and sedation. Sugammadex, which is a new agent for the reversal of neuromuscular blockade, is a modified gamma-cyclodextrin. It forms a complex with rocuronium, removes it from the circulation and terminates neuromuscular blockade. Sugammadex is a safe agent with a low risk of serious side effects. The high cost of sugammadex, which is one of the most expensive drugs in anaesthesia practice, prevents it from being used as a standard neuromuscular reversal drug. It has been suggested that the cost of sugammadex use in anaesthesia can be reduced by shortening the duration of recovery.