Suggamedex in ESRD pts

[sevoflurane]

I have to disagree about the clinical difference. My place is doing some studies about the difference in times of reversal. And it isn’t even close. Granted, we are using accelerometer and not pulling tubes until the the TOF ratio is >0.9, but the time to get there between the two is greater than double digits in minutes. And remind me, how much does a minute of OR time cost again?

Sounds 'bout right.

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[Psai]

I have to disagree about the clinical difference. My place is doing some studies about the difference in times of reversal. And it isn’t even close. Granted, we are using accelerometer and not pulling tubes until the the TOF ratio is >0.9, but the time to get there between the two is greater than double digits in minutes. And remind me, how much does a minute of OR time cost again?

I don't even know what an accelerometer looks like

 

[facted]

I have to disagree about the clinical difference. My place is doing some studies about the difference in times of reversal. And it isn’t even close. Granted, we are using accelerometer and not pulling tubes until the the TOF ratio is >0.9, but the time to get there between the two is greater than double digits in minutes. And remind me, how much does a minute of OR time cost again?

Oh absolutely. Time to max neo effect is 10ish minutes. But then again, that's why I give it more than 10 minutes before I plan on extubating. I also barely paralyze my patients giving very small roc doses and propofol boluses towards the end of the case if needed for relaxation.

 

[Robotic Wis-Hipple]

July’s Anesthesiology had study looking at Sugammadex reversal for Vec....

Bullet point take aways:

Reversal of Vec is not as bulletproof as reversal of Roc.

Neostigmine reversal (control) took like 11 minutes compared with ~2 and as we all won’t be surprised by, still had some PACU weakness.

 

[AdmiralChz]

July’s Anesthesiology had study looking at Sugammadex reversal for Vec....

Bullet point take aways:

Reversal of Vec is not as bulletproof as reversal of Roc.

Neostigmine reversal (control) took like 11 minutes compared with ~2 and as we all won’t be surprised by, still had some PACU weakness.

Of course, it was literally made to fit the rocuronium molecule specifically inside of the structure. Vecuronium is close, but not exactly the same structure.

That's why benzylquinolones aren't reversed.

Also, accelerometers? Woah I thought they were the Anesthesiology equivalent of Big Foot or Loch Ness Monster.