Summary

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• This summary is based on the review of 15 systematic review(s)/meta-analysis(es). ^[1-16]
• Effectiveness in CICV Scenarios: In critical "can't intubate, can't ventilate" (CICV) cases, sugammadex successfully restored spontaneous ventilation in 75% (6/8) of cases, while 25% (2/8) experienced obstructed breathing patterns that required surgical airway intervention.
• Efficacy in Morbidly Obese Patients: Sugammadex doses of 2 mg/kg and 4 mg/kg, based on 40% corrected body weight (CBW), effectively reversed moderate and deep neuromuscular blockade in morbidly obese patients, showing reliable and timely reversal.
• Reversal in Pediatric Populations: Sugammadex at 2 mg/kg and 4 mg/kg significantly reduced the time to achieve Train-of-Four Ratio (TOFR) of 0.9 and extubation in pediatric patients compared to controls, indicating faster recovery from neuromuscular blockade.
• Comparison to Neostigmine in Reducing Postoperative Complications: Sugammadex was superior to neostigmine in reducing postoperative pulmonary complications (PPCs) such as pneumonia and atelectasis, as well as decreasing the incidence of postoperative nausea and vomiting (PONV), particularly in settings involving volatile anesthetics.
• Perioperative Anaphylaxis: Sugammadex was associated with a rare incidence of anaphylaxis, reported between 0.02% and 0.04% in observational studies.
• Reduced Adverse Events Compared to Neostigmine: In pediatric and bariatric surgery patients, sugammadex demonstrated fewer adverse events and a lower risk of postoperative nausea and vomiting (PONV) and postoperative pulmonary complications (PPCs) compared to neostigmine.
• Sugammadex demonstrated reliable neuromuscular blockade (NMB) reversal in specific populations, including morbidly obese patients using a 40% corrected body weight dosing scalar, pediatric patients with faster reversal times and fewer adverse effects, bariatric surgery patients with faster and safer NMB reversal compared to neostigmine, and patients with neuromuscular disorders, where responses were generally successful but displayed some unpredictability in dosing effectiveness.