Anaesthetic drugs & techniques
The Impact of Quantitative Neuromuscular Monitoring and Sugammadex Reversal on Postoperative Hypoxemia in Obese Patients
Authors' conclusion
Implementation of quantitative neuromuscular monitoring with guideline-based sugammadex dosing reduced postoperative hypoxemic burden in obese patients undergoing abdominal surgery.
Study context
- Population
- Obese adults (BMI ≥30 kg/m²) undergoing elective intra-abdominal surgeryfinal analysis
- Participants
- 135 adults
- Exposure
- After vs Before
- Aftern = 67
- Beforen = 68reference
- Outcome
- Postoperative hypoxemic burden (AUC for SpO2 ≤90%), measured with a wearable continuous pulse oximetry device
- Follow-up
- First 24 hours after surgery
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
P = 0.004
Observational data: associations, not effects.
Secondary outcomes
Intraoperative rocuronium dosing
- Rocuronium use increased
- 0.31 [0.24-0.37] to 0.34 [0.27-0.41] mg·kg-1·h-1
- P = .034
Sugammadex dosing
- Sugammadex dosing doubled
- 2.3 [2.1-3.7] to 4.0 [4.0-4.1] mg/kg
- P < .0001
Postanesthesia care unit (PACU) LOS and postoperative supplemental oxygen use
- Similar
Feasibility of continuous physiological monitoring
- Continuous pulse oximetry identified substantially more hypoxemia than documented in the electronic medical record; routine use requires improvements in infrastructure and measurement systems
Original publication
The Impact of Quantitative Neuromuscular Monitoring and Sugammadex Reversal on Postoperative Hypoxemia in Obese Patients. Anesth Analg. Published 10 August 2026. doi:10.
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