Renal Injury

Anaesthesia Journal on the renal complications of anesthesia. Risk factors include  acute surgery, sepsis, age, anemia, diabetes, hypertension, vascular disease, cardiac failure, hepatic disease, pre-existing renal disease, trauma, abdominal hypertension, nephrotoxic drugs.

Small increases in Creatinine can have dramatic impacts on mortality.

A review of risk and management strategies



Don’t forget to advise female patients taking birth control of the interaction when Sugammadex was used.

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As an aside, as always neuromuscular block must be monitored to determine an adequate dose of Sugammadex. And what if reintubation is needed? Succinylcholine still works normally, and Rocuronium can be used but in the first few hours after Sugammadex it may need double the dose;  alternatively Cisatracurium is unaffected (and unreversible by Sugammadex). We are also seeing some reports of allergic reactions to Sugammadex or the complex it forms, so no it’s not a recommended treatment for Rocuronium allergic reaction.