Abstract:

Our aim is to compare neostigmin versus sugammadex in reversal of neuromuscular blockade of vecuronium after abdominal surgery of obese patients whose BMI ≥30. This study is performed on 70 patients whose BMI ≥30 and ASA I-II-III. They are 18-65 years old and scheduled for any abdominal surgery under general anesthesia. They are monitorized with TOF-watch for neuromuscular blockade and standard non-invasive monitorization. Vecuronium 0,1 mg/kg is given during anesthesia induction. According to type of surgery, extra doses of vecuronium 0.01-0.02 mg/kg is added to keep TOF between 0-2. During recovery period, when TOF number exceeds 2 and diaphragmatic movements begin, group sug received sugammadex 2 mg/kg and group neo received neostigmin 0,05 mg/kg with atropine 0,02 mg/kg. When TOF ratio becomes 0,9 and clinical evaluation is completed, patient is extubed. Group sug and neo recovery durations from TOF2 to TOF 0.9 are respectively  3,7 minutes and 14 minutes. (p<0,001)  Demographic data revealed no significant difference between Group sug and group neo except BMI and surgery type (p=0,017 , p=0,008 ). PORC(Postoperative residual curarization) is a predicted complication in obesity. Sugammadex is superior than neostigmine especially in obese critical patients in terms of effective faster and safer airway management.       

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