treat the patient with a reversal agent — typically either sugammadex
or neostigmine — at the end of the procedure to reverse its effects.
Though the guideline doesn't recommend using one reversal agent
over another, Mr. Schmidt prefers using sugammadex because evi-
dence suggests it can reverse the effects of the NMBA faster and
cause fewer adverse events than neostigmine.
3. Find a better analgesic.
Because opioids are known to have respiratory depressant effects, the
guideline suggests that facilities should carefully consider their role in
treating sleep apnea patients. "Although potent analgesics, opioids
depress breathing in all patients — and may do so more in sleep
apnea patients," says Dr. Memtsoudis. "It's probably good to reduce
the reliance on opioids in all patients when possible because of their
known side effects."
Instead, consider other non-opioid analgesics known to treat pain
without any respiratory depression, like IV NSAIDs acetaminophen or
ketorolac, says Mr. Schmidt. He notes that pre-operative gabapentin,
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