Neuromuscular Blockade and Surgical Conditions (Sugamadex)
Morbid Obesity
About this trial
This is an interventional treatment trial for Morbid Obesity focused on measuring Laparoscopic surgery, Anesthesiology, Neuromuscular blockade
Eligibility Criteria
Inclusion Criteria:
- American Society of Anesthesiologists physical status Class I-III, scheduled to undergo elective sleeve gastrectomy
Exclusion Criteria:
- Neuromuscular disorder affecting NMB
- history of malignant hyperthermia
- significant renal dysfunction
- allergy to medications used during general anesthesia
- concurrent use of medications known to interfere with NMBAs or with sugammadex (antibiotics, anticonvulsants, magnesium salts).
Sites / Locations
- Sheba Medical Center
Arms of the Study
Arm 1
Arm 2
No Intervention
Experimental
Conventional neuromuscular blockade
Profound neuromuscular blockade
The dose of rocuronium (medication used for NMB during anesthesia)will be adjusted to maintain a depth of NMB of T1 of 10-20% as assessed by a nerve stimulator. At the end of surgery patients will receive neostigmine 2.5 mg and atropine 1 mg to reverse the effect of rocuronium. Extubation will be performed when train-of-four ratio ≥ 0.9.
Rocuronium dose will be adjusted to maintain a depth of NMB of zero response to train of four and a post tetanic count of no more than 10 responses. At the end of surgery patients will receive a single bolus dose of 4 mg/kg sugammadex according to ideal body weight + 40%12. Extubation will be performed when train-of-four ratios ≥ 0.9.