Use of Reversal Options for Neuromuscular Blockade: Improving Patient Safety

This program will include a discussion of off-label treatment not approved by the FDA for use in the United States.

Program Goals

Achieving Optimal Surgical Conditions

Use of NMB

Deep NMB vs No NMB

Risk of Residual Paralysis After NMB

High Risk of Residual NMB

Complications of NMB

Postoperative Pulmonary Complications

Risk Factors for Pulmonary Complications

Preventing Complications of Residual NMB

Pros and Cons of Neostigmine

Neostigmine: Time of Effect

Sugammadex Pros and Cons

Sugammadex Dosing Recommendations

Sugammadex vs Neostigmine: Moderate NMB

Sugammadex vs Neostigmine: Moderate NMB (cont)

Sugammadex vs Neostigmine: Deep NMB

Sugammadex vs Neostigmine: Deep NMB (cont)

Good Candidates for Sugammadex

Sugammadex vs Neostigmine in the Morbidly Obese

Residual NMB in Elderly Patients

Residual NMB in Elderly Patients (cont)

How Deep NMB Improves Surgical Conditions

Selection of an Appropriate Reversal Agent

Other Considerations With Sugammadex Use

Case 1: When Sugammadex May Be Helpful

Case 2: When Sugammadex May Be Helpful

Case 2: When Sugammadex May Be Helpful (cont)

Case 3: When Sugammadex May Be Helpful

Case 3: When Sugammadex May Be Helpful (cont)

Case 4: When Sugammadex May Be Helpful

Case 5: When Sugammadex May Be Helpful

Surgery and Anesthesiology Collaboration

Conclusions

Conclusions (cont)

Abbreviations

Abbreviations (cont)