HSD91 The Influence of Patient and Hospital Characteristics in Sugammadex Usage Under General Anesthesia

Sugammadex is a novel neuromuscular blockade (NB) reversal agent that has demonstrated faster and more predictable than acetylcholinesterase inhibitors such as neostigmine. Despite published literature on cost/benefit utilization, financial concerns of broad implementations sugammadex usage have been noted. To understand potential demographic differences between neostigmine use, we examined baseline characteristics patients who received either or during common abdominal surgeries requiring intra- perioperative NB. Using large, de-identified US electronic health record database (Cerner Real-World Data), extracted data from all adult (≥18 years) underwent an inguinal hernia surgery, exploratory laparotomy, cholecystectomy, appendectomy January 2016 May 2021, using ICD-10-PCS Current Procedural Terminology codes, included those intra/perioperative rocuronium- vecuronium-induced Patient Charlson Comorbidity Index (CCI) were compared across both NB agents used intraoperatively. Out 74,088 surgeries, 30,716 (41%) sugammadex. Compared to neostigmine, administration occurred frequently in men women (41.8% vs. 40.5%), obese underweight (43.4% 41.5%), aged 60+ 18-59 40.3%). Patients with CCI 4+ scores 0 (49.3% 41.1%). Hispanic/Latinx the least likely out ethnic groups (29.3% 41.5%). Furthermore, Medicare Medicaid had highest rate receiving (42.8% 43.3% respectively), followed by self-paying (42.0%) commercially insured (39.7%). This study indicates certain patient demographics may influence healthcare providers’ decision administer over inhibitors. Future studies are required whether other surgical procedures which require show similar trends and/or variances administration, highlight any disparities access care.