Article Notes
The actual cost of both operating theatre and recovery room time in the U.S., Canada, Australia and greater Europe is likely much, much higher than figures used by the researchers. Thus even at its current high cost there is a strong economic argument to be made for using sugammadex for routine reversal.
However, the opposing point is that the economic benefit is only real if the liberated operating room time can actually be utilised for productive surgical work – this is currently unlikely in many hospitals due to inefficient and inflexible scheduling.
As the evidence-base increases and the cost falls, it will be indications #2 and #4 that carry our shift in practice to using sugammadex and its successors. We will recognise larger groups of patients for whom residual paralysis is detrimental (everyone?) while simultaneously appreciating better how common the problem truly is.