The Impact of Sugammadex on Ileus After Abdominal Wall Reconstruction

Exclusion Criteria

• •Known serious or severe hypersensitivity reaction to sugammadex or any of the ingredients in sugammadex.
• •Hernias with fascial defects \> 20cm wide
• •Concomitant treatment with a strong or moderate cytochrome P450 3A4 inhibitor (e.g., Ketoconazole and other anti-fungals, Clarithromycin, HIV protease inhibitors, diltiazem, erythromycin, verapamil) or strong CYP3A4 inducers (e.g., rifampin).
• •Known small bowel obstruction (SBO) at the time of hernia repair
• •Suspected SBO or at risk of recurrent SBO at the time of hernia repair - at the discretion of the staff surgeon.
• •Nasogastric (NG), orogastric (OG), or gastric (eg. PEG) in place at the time of hernia repair and left in beyond the morning of the first postoperative day.
• •Patients with a stoma.
• •Cancer with increased risk of gastro-duodenal perforation (e.g., infiltrative gastrointestinal tract malignancy, recent gastrointestinal tract surgery, diverticular disease including diverticulitis, ischemic colitis, or concomitantly treated with bevacizumab) - at the discretion of the staff surgeon.
• •Disorder that could alter the integrity of the gastrointestinal lining (e.g., Crohn's disease) - at the discretion of the staff surgeon.
• •Severe hepatic failure (Child-Pugh Class C).
• •Clinically relevant hepatic failure (e.g. cirrhosis) - at the discretion of the staff surgeon.
• •Severe renal failure (GFR\<30ml/min, on dialysis, or have an arteriovenous fistula, indwelling hemodialysis catheter or peritoneal dialysis catheter) - at the discretion of the staff surgeon.
• •Pregnant or planning to become pregnant during study period.
• •Breastfeeding or planning to breastfeed during study period.
• •Clinically relevant alteration of the blood-brain-barrier - at the discretion of the staff surgeon.
• •Other contraindication to sugammadex as documented by a physician.
• •Unable to give informed consent; vulnerable populations; non-English speaking.
• •Emergent operation.
• •Undergoing minimally invasive approaches.
• •Undergoing repair with mesh placed in a position other than retromuscular.
• •Chronic opioid users, as defined by the daily use of opioids for at least 90 days within the past year
• •Inability to safely extubate the patient at the end of the surgery for any reason, as determined by the operative team.