Impact of sugammadex and neostigmine on outcome after major orthopaedic surgery: A population-based analysis
Authors' conclusion
Population-based data indicate that sugammadex and neostigmine both appear highly effective in reducing the odds of severe life-threatening pulmonary complications. Sugammadex, especially, was associated with reduced odds of cardiac complications.
Study context
- Population
- US patients undergoing total hip/knee arthroplasty (THA), TKA or lumbar spine fusion surgery, 2016–2019, who received NMBAs
- Participants
- 361,553 patients
- Exposure
- Sugammadex vs neostigmine vs no reversal agent
- Outcome
- Pulmonary complications, cardiac complications and need for postoperative ventilation
Methodological detailspopulation-based, national claims data (Premier Healthcare), mixed-effects regression, Bonferroni-adjusted P values
- Population-based
- National claims data (Premier Healthcare)
- Mixed-effects regression
- Bonferroni-adjusted P values
Main finding
As reported in the abstract
Cardiac and pulmonary complications
Odds ratio (95% CI)
Sugammadex vs Neostigminecardiac complications
0.86(0.80–0.92)
Sugammadex vs Controlscardiac complications
0.83(0.78–0.89)
Sugammadex vs Controlspulmonary complications
0.85(0.77–0.94)
Neostigmine vs Controlspulmonary complications
0.91(0.85–0.98)
Sugammadex vs Controlssevere pulmonary complications incl. invasive ventilation
0.54(0.45–0.64)
Neostigmine vs Controlssevere pulmonary complications incl. invasive ventilation
0.53(0.46–0.6)
Observational data: associations, not effects.
Further findings
| Outcome | Sugammadex | Neostigmine |
|---|---|---|
| Use of reversal agents | 20.7% | 53.8% |
- Use of reversal agents — Received either agent
- 74.5%
- Use of reversal agents — Sugammadex use 2016 to 2019
- 4.4% to 35.4%
- Use of reversal agents — Neostigmine use 2016 to 2019
- 64.5% to 43.4%
Original publication
Impact of sugammadex and neostigmine on outcome after major orthopaedic surgery: A population-based analysis. Eur J Anaesthesiol. Published 15 March 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →