Perioperative medicine & outcomes
Association Between Neuromuscular Blockade and Its Reversal With Postoperative Delirium in Older Patients: A Hospital Registry Study
Authors' conclusion
Neuromuscular blockade during general anesthesia is dose-dependently associated with a higher risk of postoperative delirium. The administration of reversal agents mitigates this risk
Study context
- Population
- Adult hospitalised patients aged ≥60 years undergoing GA for noncardiac, nonneurosurgical, nontransplant procedures, Massachusetts, 2008–2024
- Participants
- 53,772 participants
- Exposure
- Intraoperative ND-NMBA administration vs none
- ND-NMBAn = 43,723
- Outcome
- Delirium (chart keyword search with manual review, CAM assessments, ICD codes)
- Follow-up
- 7 days
Methodological detailshospital registry, tertiary health care network
- Hospital registry
- Tertiary health care network
Main finding
As reported in the abstract
Adjusted odds ratio (95% CI)P value
ND-NMBA vs No ND-NMBA
1.15(1.01–1.31)
P = 0.038ND-NMBAper unit increase in ED95 dose
1.09(1.06–1.12)
P < 0.001Observational data: associations, not effects.
Further findings
| Outcome | aOR (95% CI) | P value | |
|---|---|---|---|
| Impaired neuromuscular recovery (preextubation TOFR <95), reversal vs no reversal38,143 (87.2%) ND-NMBA patients received reversal | 0.60 (0.49–0.74) | P < 0.001 | |
| Delirium, reversal vs no reversal | 0.73 (0.64–0.83) | P < 0.001 | |
| Delirium, neostigmine vs sugammadex | 0.91 (0.73–1.12) | P = 0.36 | |
| 0.512Adjusted odds ratio (log scale) |
Delirium with ND-NMBA, by reversal agent use (subgroup)
| aOR (95% CI) | P value | ||
|---|---|---|---|
| ND-NMBA with reversal | 1.07 (0.94–1.23) | P = 0.30 | |
| ND-NMBA without reversal | 1.52 (1.28–1.79) | P < 0.001 | |
| 0.512Adjusted odds ratio (log scale) |
Original publication
Association Between Neuromuscular Blockade and Its Reversal With Postoperative Delirium in Older Patients: A Hospital Registry Study. Anesth Analg. Published 18 April 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →