Anesthesiology
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Current practice guidelines do not address the use of neuromuscular blocking and antagonism agents in patients with renal impairment. The FDA label for sugammadex advises against use in patients with severe renal impairment (eGFR < 30 ml/min). Using a multicenter electronic health record registry, we sought to understand the modern use of neuromuscular blockade and antagonism agents in patients with significant renal impairment (eGFR < 60 ml/min). ⋯ Rocuronium-sugammadex is the primary neuromuscular blockade-antagonism strategy for patients with moderate and severe renal impairment. Variation in choice is significantly impacted by the institution and attending anesthesiologist providing care.