Sugammadex and Acceleromyography Used During a Lensectomy in a Sea Lion (Zalophus californianus)

Neuromuscular blocking agents (NMBAs) are essential in intraocular surgeries to improve surgical conditions and ensure optimal ventilation. However, residual blockade can pose significant risks, particularly in pinnipeds due to their unique diving physiology. This case report describes the use of sugammadex for reversing rocuronium and AMG for monitoring neuromuscular block (NMB) in a California sea lion undergoing lensectomy. The objective is to evaluate the feasibility and safety of sugammadex for reversal of rocuronium-induced neuromuscular blockade and acceleromyography (AMG) for monitoring neuromuscular function in pinnipeds, with the goal of improving anesthetic management and recovery. Rocuronium (0.3 mg/kg IV) was used to achieve complete NMB, and an additional 0.1 mg/kg IV was administered to prolong the block. Sugammadex (1 mg/kg IV) reversed the NMB, with recovery within 90 s. Neuromuscular function was monitored using AMG, with the ulnar nerve of the foreflipper as the stimulation site. AMG allowed for an objective assessment of neuromuscular function, ensuring accurate titration of the NMBA and reversal agent. This is the first report documenting the use of sugammadex for the reversal of rocuronium and AMG for neuromuscular monitoring in a sea lion. This successful application highlights the potential of these techniques to improve anesthesia protocols, patient safety, and welfare in marine mammal medicine.