Sugammadex vs Neostigmine/Glycopyrrolate on Urinary Retention After Spine Surgery

Subjects requiring elective ambulatory posterior lumbar laminectomy, will receive either an intravenous infusion bolus of Sugammadex (2 mg/kg dosed by actual body weight) or intravenous infusion bolus of Neostigmine (50 μg/kg, up to 5 mg maximum dose) plus Glycopyrrolate (10 μg/kg, up to 1 mg maximum dose). Additionally, all subjects will receive hospital standard of care therapy for their surgery and hospital stay.

Inclusion criteria

• Age ≥ 18 years
• ASA Physical Status I-III

Exclusion criteria

• Inability to obtain written informed consent
• Allergy to medications used in the protocol
• Known or suspected neuromuscular disorders
• Significant renal disease with a serum creatinine ≥ 2 mg/dL
• Significant liver disease
• A family history of malignant hyperthermia
• History of genitourinary surgery, cancer, or radiation within the last year
• Currently prescribed urological medications or diuretics
• BPH or symptoms of BPH (interrupted or weak urine stream or wake up to urinate more than two times per night)
• History or diagnosis of urinary incontinence or urinary retention
• History of PONV with use of scopolamine
• Use of Foley catheter pre- or intra- operatively
• Perioperative medications that influence micturition (e.g., diuretics or intraoperative anticholinergic medication use other than NMB reversal)