{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T14:32:52Z","timestamp":1793111572241,"version":"4.5.0"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"University of South Carolina","id":[{"id":"https:\/\/ror.org\/02b6qw903","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["OBES SURG"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Residual effects from general anesthesia can delay the time until oral intake and ambulation. Reversal with Sugammadex has been shown to improve outcomes and decrease post-operative nausea and vomiting. The benefits amongst the bariatric population have not been ascertained. We hypothesized that the use of Sugammadex for reversal will decrease the length of stay (LOS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Procedures<\/jats:title>\n                    <jats:p>This is a single center retrospective review of 961 patients who underwent elective bariatric surgery from January 2023 to January 2025. Inclusion criteria were any patient undergoing elective bariatric surgery who received either Sugammadex or neostigmine. Our exclusion criteria were any emergent or open procedures. The decision to administer either Sugammadex or neostigmine was up to the discretion of the anesthesiologist. Sugammadex was used in 355 patients and neostigmine for reversal in 606 patients. The primary outcome was the length of stay. Multivariable regression models were used to adjust various variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Median LOS was 2 nights in the Sugammadex group versus 3 nights in the neostigmine group. The proportion of prolonged stays (&gt;\u20092 nights) was 27.9% for Sugammadex (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.007) versus 72.1% for neostigmine (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004). In multivariable logistic regression, sugammadex was independently associated with lower odds of prolonged LOS (OR\u2009=\u20090.55, 95% CI 0.37\u20130.82,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004) while neostigmine was associated with increased odds of prolonged LOS (OR\u2009=\u20091.866, 95% CI 1.23\u20132.83,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003). Higher complexity procedures and higher BMI were also independent predictors of increased LOS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Sugammadex use was associated with significantly lower odds of prolonged hospital stay following elective bariatric surgery. Procedure complexity and higher BMI were also independent predictors. Further prospective studies are warranted to confirm these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11695-026-08910-z","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:08:16Z","timestamp":1787616496000},"page":"5731-5735","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Does Sugammadex Decrease Length of Stay in Bariatric Surgery? Experience from an MBSAQIP Comprehensive Bariatric Center"],"prefix":"10.1007","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-5912-3589","authenticated-orcid":false,"given":"Dominick","family":"Ricci","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashton","family":"Norris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ratna","family":"Pallapothu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,25]]},"reference":[{"key":"8910_CR1","doi-asserted-by":"publisher","first-page":"1027","DOI":"10.1016\/S0140-6736(23)02750-2","volume":"403","author":"N Phelps","year":"2024","unstructured":"Phelps N, Singleton R, Zhou B, et al. Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults. Lancet. 2024;403:1027\u201350.","journal-title":"Lancet"},{"issue":"4","key":"8910_CR2","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1016\/j.soard.2019.12.022","volume":"16","author":"WJ English","year":"2020","unstructured":"English WJ, DeMaria EJ, Hutter MM, et al. American Society for Metabolic and Bariatric Surgery 2018 estimate of metabolic and bariatric procedures performed in the United States. Surg Obes Relat Dis. 2020;16(4):457\u201363. https:\/\/doi.org\/10.1016\/j.soard.2019.12.022.","journal-title":"Surg Obes Relat Dis"},{"issue":"6","key":"8910_CR3","doi-asserted-by":"publisher","first-page":"1023","DOI":"10.1097\/XCS.0000000000001052","volume":"238","author":"T Bharani","year":"2024","unstructured":"Bharani T, Tavakkoli A, Tsai TC, Robinson MK, Sheu EG. Safety of Same-Day Discharge after Bariatric Surgery: Retrospective 6-Year North American Analysis. J Am Coll Surg. 2024;238(6):1023\u201334. https:\/\/doi.org\/10.1097\/XCS.0000000000001052.","journal-title":"J Am Coll Surg"},{"issue":"4","key":"8910_CR4","doi-asserted-by":"publisher","first-page":"978","DOI":"10.1097\/ALN.0000000000005828","volume":"144","author":"CA Hagberg","year":"2026","unstructured":"Hagberg CA, Asai T, Heidegger T, Myatra SN, Pandit JJ, Jiang Y. Era of sugammadex: A paradigm shift in airway management. Anesthesiology. 2026;144(4):978\u201397. https:\/\/doi.org\/10.1097\/ALN.0000000000005828","journal-title":"Anesthesiology"},{"issue":"1","key":"8910_CR5","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1097\/ALN.0000000000004379","volume":"138","author":"SR Thilen","year":"2023","unstructured":"Thilen SR, Weigel WA, Todd MM, Dutton RP, Lien CA, Grant SA, Szokol JW, Eriksson LI, Yaster M, Grant MD, Agarkar M, Marbella AM, Blanck JF, Domino KB. American society of anesthesiologists practice guidelines for monitoring and antagonism of neuromuscular blockade: A report by the American society of anesthesiologists task force on neuromuscular blockade. Anesthesiology. 2023;138(1):13\u201341. https:\/\/doi.org\/10.1097\/ALN.0000000000004379","journal-title":"Anesthesiology"},{"issue":"2","key":"8910_CR6","doi-asserted-by":"publisher","first-page":"737","DOI":"10.1111\/cts.12941","volume":"14","author":"K Mostoller","year":"2021","unstructured":"Mostoller K, Wrishko R, Maganti L, Herring WJ, van Zutphen-van Geffen M. Pharmacokinetics of Sugammadex Dosed by Actual and Ideal Body Weight in Patients With Morbid Obesity Undergoing Surgery. Clin Transl Sci. 2021;14(2):737\u201344. https:\/\/doi.org\/10.1111\/cts.12941.","journal-title":"Clin Transl Sci"},{"key":"8910_CR7","doi-asserted-by":"publisher","first-page":"1495","DOI":"10.1016\/j.ijsu.2014.07.013","volume":"12","author":"E Von Elm","year":"2014","unstructured":"Von Elm E, Altman DG, Egger M, et al. 28The Strengthening of the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for reporting observational studies. Int J Surg. 2014;12:1495\u20139.","journal-title":"Int J Surg"},{"issue":"5","key":"8910_CR8","first-page":"599","volume":"35","author":"AP Moss","year":"2022","unstructured":"Moss AP, Powell MF, Morgan CJ, Tubinis MD. Sugammadex versus neostigmine for routine reversal of neuromuscular blockade and the effect on perioperative efficiency. Proc (Bayl Univ Med Cent). 2022;35(5):599\u2013603. PMID: 35991723; PMCID: PMC9373753.","journal-title":"Proc (Bayl Univ Med Cent)"},{"issue":"1","key":"8910_CR9","doi-asserted-by":"publisher","first-page":"33","DOI":"10.2174\/1574886318666230302124634","volume":"19","author":"R Chhabra","year":"2024","unstructured":"Chhabra R, Gupta R, Gupta LK. Sugammadex versus neostigmine for reversal of neuromuscular blockade in adults and children: A systematic review and meta-analysis of randomized controlled trials. Curr Drug Saf. 2024;19(1):33\u201343. 10.2174\/1574886318666230302124634. https:\/\/doi.org\/10.2174\/1574886318666230302124634","journal-title":"Curr Drug Saf"},{"issue":"6","key":"8910_CR10","doi-asserted-by":"publisher","first-page":"1129","DOI":"10.1213\/ANE.0000000000004028","volume":"128","author":"SD Grabitz","year":"2019","unstructured":"Grabitz SD, Rajaratnam N, Chhagani K, Thevathasan T, Teja BJ, Deng H, Eikermann M, Kelly BJ. The effects of postoperative residual neuromuscular blockade on hospital costs and intensive care unit admission: A population-based cohort study. Anesth Analg. 2019;128(6):1129\u201336. . https:\/\/doi.org\/10.1213\/ANE.0000000000004028","journal-title":"Anesth Analg"},{"key":"8910_CR11","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1016\/j.jclinane.2018.12.042","volume":"55","author":"L Saager","year":"2019","unstructured":"Saager L, Maiese EM, Bash LD, Meyer TA, Minkowitz H, Groudine S, Philip BK, Tanaka P, Gan TJ, Rodriguez-Blanco Y, Soto R, Heisel O. Incidence, risk factors, and consequences of residual neuromuscular block in the United States: The prospective, observational, multicenter RECITE-US study. J Clin Anesth. 2019;55:33\u201341. Epub 2018 Dec 27. PMID: 30594097.","journal-title":"J Clin Anesth"},{"issue":"3","key":"8910_CR12","doi-asserted-by":"publisher","first-page":"823","DOI":"10.1007\/s11695-025-07705-y","volume":"35","author":"P Crosby","year":"2025","unstructured":"Crosby P, Smolkin C, Sanicola C, Rosenbluth A, Pryor A, Swaszek L, Fuller S, Spaniolas K. Effect of Sugammadex on Post-operative Urinary Retention After Bariatric Surgery. Obes Surg. 2025;35(3):823\u20138. https:\/\/doi.org\/10.1007\/s11695-025-07705-y. Epub 2025 Feb 12. PMID: 39934519.","journal-title":"Obes Surg"},{"issue":"3","key":"8910_CR13","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1097\/XCS.0000000000000063","volume":"234","author":"MC Bamdad","year":"2022","unstructured":"Bamdad MC, Brown CS, Kamdar N, Weng W, Englesbe MJ, Lussiez A, Patient. Surgeon, or Hospital: Explaining Variation in Outcomes after Colectomy. J Am Coll Surg. 2022;234(3):300\u20139. PMID: 35213493; PMCID: PMC10369366.","journal-title":"J Am Coll Surg"}],"container-title":["Obesity Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11695-026-08910-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11695-026-08910-z","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11695-026-08910-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T13:36:00Z","timestamp":1793108160000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11695-026-08910-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,25]]},"references-count":13,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["8910"],"URL":"https:\/\/doi.org\/10.1007\/s11695-026-08910-z","relation":{},"ISSN":["0960-8923","1708-0428"],"issn-type":[{"value":"0960-8923","type":"print"},{"value":"1708-0428","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,25]]},"assertion":[{"value":"5 June 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 June 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 August 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 August 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}]}}