Sugammadex is a medication used for reversal of muscle relaxation during procedures under general anesthesia. It works by encapsulating muscle relaxant molecules with a steroid ring in its structure. On the other hand, postoporative nause and vomiting (PONV) is an adverse outcome during anesthesia. PONV can be prevented with pharmacologic agents such as ondansetron and dexamethasone. Dexamethasone is a steroidal agent that can interact with sugammadex. In theory, this interaction could lead to reduced effectiveness of sugammadex. In fact, several studies have explored this interaction. However, the effect of sugammadex on the antiemetic effect of dexamethasone has not been evaluated. This study intends to evaluate this interaction.

The study will use de-identified retrospective data to conduct a cross-sectional study to determine the effect of sugammadex on the antiemetic efficacy of dexamethasone in elective adult surgical patients who underwent surgery in a tertiary care center between January 1 2023 and January 1 2024 . The investigators will conduct univariate and multivariate analysis to assess the effect.

Inclusion Criteria:

• Older than 18 years old
• Elective surgery
• ASA 1, 2, 3
• At least one risk factor for PONV

Exclusion Criteria:

• Pregnancy
• Receiving antiemetics prior to arrival to preoperative holding area
• Receiving opioids prior to arrival to preoperative holding area
• Admission to ICU
• Altered mental status
• Rapid sequence induction
• Nausea or vomiting before surgery

Adult surgical patients scheduled for elective surgery

Data are de-identified. The data used for data analysis can be available upon request