Neostigmine Versus Sugammadex for Reversal of Neuromuscular Blockade in Elderly Patients: A Blinded Randomised Study
Authors' conclusion
Time to TOF ≥ 0.9 was shorter after reversal with sugammadex 2 mg kg-1 compared to neostigmine/glycopyrrolate 50/10 μg kg-1 in elderly patients administered rocuronium during total intravenous anaesthesia.
Study context
- Population
- Patients aged ≥ 75 years, American Society of Anesthesiologists (ASA) I–IV, scheduled for robotic-assisted laparoscopic surgery under TIVA with rocuronium, depth of neuromuscular blockade (NMB) from TOF count 2 to TOF ratio < 0.6040 evaluated for primary outcome
- Participants
- 41 patients
- Comparison
- Sugammadex vs Neostigmine
- Sugammadexn = 23
- Neostigminen = 17reference
- Primary endpoint
- Time to TOF ≥ 0.9, measured from start of reversal agent administration
Methodological detailsblinded
- Blinded
Primary result
Time to TOF ≥ 0.9
Difference
427 s
95% CI 205–648
By group
Sugammadex vs Neostigmine
difference 427 s (95% CI 205–648)
As reported in the abstract
Secondary outcomes
Clinical signs of residual NMB · within 90 min after reversal agent
- No difference in occurrence of clinical signs of residual NMB
Original publication
Neostigmine Versus Sugammadex for Reversal of Neuromuscular Blockade in Elderly Patients: A Blinded Randomised Study. Acta Anaesthesiol Scand. Published 27 November 2025. doi:10.
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