SummaryTo date, the dosing of sugammadex is based on real body weight without taking fat content into account. We compared the reversal of profound rocuronium-induced neuromuscular blockade in morbidly obese patients using doses of sugammadex based on four different weight corrections. One hundred morbidly obese patients, scheduled for laparoscopic bariatric surgery under propofolsufentanil anaesthesia, were randomly assigned four groups: ideal body weight; ideal body weight + 20%; ideal body weight + 40%; and real body weight. Patients received sugammadex 2 mg.kg

Objective: To report the clinical features, outcomes, and prognostic factors associated with the surgical treatment of epiploic foramen entrapment (EFE). Study design: Retrospective study at a single referral hospital. Animals: Horses (n = 142) undergoing surgery (n = 145) for EFE. Methods: Preoperative, perioperative, and postoperative data of surgeries on horses that underwent exploratory laparotomy for EFE were obtained. The postoperative outcome was assessed by follow-up telephone calls with the owners/caregivers. Factors associated with postoperative reflux (POR), relaparotomy, hospital discharge, colic after hospital discharge, and survival after discharge were assessed. Results: In total, 145 surgeries were performed on 142 horses (recurrence rate, 3%). Warmblood horses represented 85% of the horses that underwent surgery. Windsucking/crib-biting was confirmed in 60% of these surgery cases. Left-to-right entrapment was diagnosed in all horses. Ileal involvement was recorded in 74% of the cases. Uncontrollable intraoperative hemorrhage was encountered in 6% of the surgeries. One hundred seven (74%) horses recovered from surgery, and 65% of those survived to discharge. The rate of survival to discharge of all surgeries was 48%. The median survival of the cases that were discharged exceeded 3193 days. Horses requiring intestinal resection were predisposed to POR, and those undergoing jejunoileostomy were more prone to POR than those undergoing jejunojejunostomy. Horses with POR were less likely to be discharged than those without POR, and those that underwent resection had shorter life expectancy after hospital discharge than those that did not undergo resection. Conclusion: Surgical treatment of EFE was associated with high morbidity and mortality, with recurrence in at least 3% of surviving horses. Clinical significance: Owners of horses with EFE should be informed of the guarded prognosis associated with current surgical treatment.

OBJECTIVE To evaluate outcomes following treatment of sarcoids in equids and to identify risk factors for treatment failure in these patients. DESIGN Retrospective case series. ANIMALS 230 equids with 614 sarcoids. PROCEDURES Records were searched to identify equids treated for ≥ 1 sarcoid between 2008 and 2013. A standardized protocol was used to determine treatment choice (electrosurgery, electrosurgery with intralesional placement of cisplatin-containing beads, topical administration of imiquimod or acyclovir, cryosurgery, bacillus Calmette-Guerin vaccine injection, or intralesional injection of platinum-containing drugs). Data regarding animal, tumor, treatment, and outcome variables were collected. Complete tumor regression without recurrence for ≥ 6 months was considered a successful outcome. Success rates were calculated; binary logistic regression analysis was used to identify risk factors for treatment failure and to compare effects of the 2 topical treatments. A χ(2) test was used to compare effects of the number of Bacillus Calmette-Guerin vaccine or cisplatin-containing drug injections on outcome. RESULTS The overall success rate was 460 of 614 (74.9%). Electrosurgical excision resulted in the highest treatment success rate (277/319 [86.8%]); odds of treatment failure were significantly greater for intralesional injection of platinum-containing drugs, cryosurgery, and topical acyclovir treatment. Odds of treatment failure were also significantly greater for sarcoids on equids with multiple tumors than for solitary lesions, and significantly lower for sarcoids on equids that received concurrent immunostimulating treatment for another sarcoid than for those on patients that did not receive such treatment. CONCLUSIONS AND CLINICAL RELEVANCE Selection bias for treatments was inherent to the study design; however, results may assist clinicians in selecting treatments and in determining prognosis for equids with sarcoids treated according to the described methods.

Objective: To determine the incidence of infection and associated risk factors, after elective arthroscopy.Study design: Retrospective case study.Animals: Horses (n51079) undergoing elective arthroscopy.Methods: Medical records of all horses that underwent elective arthroscopy between 2006 and 2013 were reviewed. Age, gender, breed, surgeon, number of joints operated, total anesthetic time, perioperative antimicrobial administration, and the presence and size of osteochondral fragments/subchondral lesions were recorded. For each operated joint, the development of postoperative infection (surgical site infection [SSI] and/or septic arthritis) and long-term outcome (>6 months) were recorded. Multivariate logistic regression was used to test for association between the independent variables and the dependent outcomes.Results: A total of 1741 joints in 1079 horses underwent arthroscopy. SSI without septic arthritis occurred in 1 fetlock joint (0.14%), 1 tibiotarsal joint (0.19%), and 6 femoropatellar joints (1.67%). Thirteen joints (0.75%) were diagnosed with septic arthritis, including 1 fetlock joint (0.14%), 4 tibiotarsal joints (0.74%), and 8 femoropatellar joints (2.23%). The probability of postoperative SSI was higher when large lesions (>40 mm long) were treated, compared to medium (20-40 mm, P 5 .005) and small (<20 mm, P < .001) lesions. SSI was a significant risk factor for the development of septic arthritis (P < .001). Although age did not affect the incidence of SSI, increasing age was associated with a lower rate of septic arthritis rate (P 5 .028).Conclusion: Septic arthritis after elective arthroscopy was more likely in the presence of SSI and younger age. Horses with large lesions were at risk for SSI, which translated into a higher incidence of postoperative septic arthritis after femoropatellar arthroscopy.

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