Abstract
OBJECTIVE: The aim of this study was to evaluate the effect of sugammadex on the quality of postoperative recovery among patients undergoing laparoscopic bariatric surgery. METHODS: In this randomized controlled trial, 60 patients scheduled for laparoscopic bariatric surgery were allocated to receive either neostigmine (N group) or sugammadex (S group) for neuromuscular blockade reversal. At the conclusion of surgery, the N group received intravenous neostigmine 0.04 mg/kg with atropine 0.02 mg/kg, while the S group received intravenous sugammadex 2 mg/kg. The primary outcome was the Quality of Recovery-15 (QoR-15) score at 24 hours postoperatively. Secondary outcomes included anesthesia recovery time, time to train-of-four (TOF) ratio ≥ 0.9, extubation time, time to achieve a modified Aldrete score ≥ 9, Richmond Agitation-Sedation Scale (RASS) scores, Visual Analogue Scale (VAS) pain scores after extubation, and time to first postoperative flatus/defecation. RESULTS: QoR-15 scores at 24 hours postoperatively were significantly higher in the S group compared with the N group (p < 0.001), with the intergroup Cohen's d was 1.547 (95% CI: 1.014 to 2.293). The S group demonstrated shorter anesthesia recovery time, time to achieve TOF ratio ≥ 0.9, extubation time, and time to modified Aldrete score ≥ 9 (p < 0.05). RASS scores immediately and 10 minutes after extubation were higher in the S group (p < 0.05). No significant differences were observed between groups in VAS pain scores at any postoperative time point or in total opioid consumption (p > 0.05). Time to first postoperative flatus/defecation were shorter in the S group (p < 0.05). CONCLUSION: The sugammadex administration in patients undergoing laparoscopic bariatric surgery could expedite reversal of neuromuscular blockade, shorten anesthesia recovery time, and facilitate gastrointestinal function restoration. It also improved postoperative quality of recovery without elevating pain intensity or increasing opioid consumption.