Cardiothoracic & vascular anesthesia
Impact of neuromuscular block monitoring and reversal on postoperative pulmonary complications in thoracic surgery: a Bayesian analysis of the iPROVE-OLV trial
Authors' conclusion
Utilising neuromuscular monitoring and reversal agents significantly reduced the risk of PPCs in thoracic surgery. Sugammadex was more efficacious in reducing PPCs compared with neostigmine.
Study context
- Population
- Patients undergoing thoracic surgery with OLV
- Participants
- 698 patients
- Comparison
- Any neuromuscular monitoring and any reversal vs neither
- Monitoring and reversaln = 657
- Without eithern = 41reference
- Primary endpoint
- Composite of PPCs
- Follow-up
- First 7 postoperative days
Methodological detailspost hoc, Bayesian analysis, multicentre
- Post hoc
- Bayesian analysis
- Multicentre
Primary result
As reported in the abstract
Monitoring and reversal vs NeitherOdds ratio (95% CrI)
CrI; lower bound of range depending on prior model
0.67(0.39–1.11)
CrI; upper bound of range depending on prior model
0.84(0.48–1.37)
- Probability of benefit (OR <1)
- between 77% and 94%
Further findings
Postoperative pulmonary complications (PPCs), sugammadex vs neostigmine (subgroup)
- Sugammadex more effective than neostigmine; probability of benefit
- 97%
PPCs, monitoring and reversal evaluated separately (subgroup)
- Both neuromuscular monitoring and reversal reduced PPCs with a high probability of benefit
Original publication
Impact of neuromuscular block monitoring and reversal on postoperative pulmonary complications in thoracic surgery: a Bayesian analysis of the iPROVE-OLV trial. Br J Anaesth. Published 1 February 2025. doi:10.
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