Perioperative medicine & outcomes
Association between choice of reversal agent for neuromuscular block and postoperative pulmonary complications in patients at increased risk undergoing non-emergency surgery: STIL-STRONGER, a multicentre matched cohort study
Authors' conclusion
In a cohort of patients at increased risk for pulmonary complications compared with neostigmine, use of sugammadex was independently associated with reduced risk of subsequent development of pneumonia or respiratory failure.
Study context
- Population
- Adults (≥18 yr) at increased risk of PPCs (ASA 3 or 4, intrathoracic or intra-abdominal surgery, aged >80 yr or procedure >2 h) undergoing non-emergency surgery under GA with tracheal intubation, NMB and reversal; Multicenter Perioperative Outcomes Group data3,817 matched pairs
- Participants
- 3,817 vs 3,817
- Exposure
- Sugammadex vs neostigmine for reversal of NMB
- Sugammadexn = 3,817
- Neostigminen = 3,817reference
- Outcome
- Composite of:
- Pneumonia
- Respiratory failure
Methodological detailssecondary analysis of the STRONGER study, multicentre
- Secondary analysis of the STRONGER study
- Multicentre
Main finding
As reported in the abstract
Odds ratio
0.41
P < 0.01
Sugammadex
Adjusted odds ratio
0.39
P < 0.0001
adjusted for unbalanced covariates
Observational data: associations, not effects.
Original publication
Association between choice of reversal agent for neuromuscular block and postoperative pulmonary complications in patients at increased risk undergoing non-emergency surgery: STIL-STRONGER, a multicentre matched cohort study. Br J Anaesth. Published 9 June 2022. doi:10.
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