The Effect of Sugammadex Versus Neostigmine on Postoperative Pulmonary Complications

Summary

Substantial respiratory morbidity has been associated with postoperative residual paralysis, which is fairly common after general anesthesia involving a neuromuscular blocking agent. Common practice in United States is to reverse neuromuscular blockade with neostigmine at the end of surgery. A new drug with evidence of more complete neuromuscular reversal has been developed, sugammadex. The objective of this study is to determine if a strategy of rocuronium neuromuscular reversal with sugammadex will reduce the proportion of subjects with any postoperative pulmonary complication, compared to neostigmine.

Timeline

Start

2017-01-24

Primary completion

2018-04-30

Completion

2018-04-30

Outcome

Missed primary endpoint

paper There was no significant difference in the primary endpoint of postoperative pulmonary complications PMID 32139135 ↗

paper 33% vs 40%; odds ratio [OR]=0.74; 95% confidence interval [CI]=[0.40, 1.37]; P=0.30 PMID 32139135 ↗

Publications

• Togioka BM, Yanez D, Aziz MF, Higgins JR, Tekkali P, Treggiari MM. Randomised controlled trial of sugammadex or neostigmine for reversal of neuromuscular block on the incidence of pulmonary complications in older adults undergoing prolonged surgery. Br J Anaesth. 2020 May;124(5):553-561. doi: 10.1016/j.bja.2020.01.016. Epub 2020 Mar 2.

Drugs

Evaluation	Drug	Modality	Dose	Route
Comparator	Neostigmine	Other / unclassified	0.07 mg/kg	Intravenous
Subject	Sugammadex	Other / unclassified	2 mg/kg	Intravenous

Indications

No indication recorded.