Sugammadex safety considerations span across patient populations with renal impairment, pediatric patients, and pregnant or breastfeeding individuals, requiring nuanced clinical decision-making based on current evidence and ongoing research.• Sugammadex reversal of moderate blockade is safe and faster than using neostigmine/cisatracurium for patients with renal impairment• Quantitative neuromuscular monitoring is essential to ensure adequate reversal (TOF >90%)• FDA approval exists for children 2+ years with the same dosing parameters as adults• Infants <2 years require special consideration due to immature neuromuscular systems and distinct physiology• Recurarization cases exist but are rare, primarily in very young patients• Pregnancy considerations include theoretical concerns about progesterone binding• Breastfeeding compatibility varies based on lactation stage, with early postpartum period requiring more caution• Continued research needed to establish definitive guidelines, especially for neonates, infants, and lactating patientsFor show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/250-sugammadex-in-special-populations-what-every-anesthesia-professional-needs-to-know/© 2025, The Anesthesia Patient Safety Foundation

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