Post-operative urinary retention is impacted by neuromuscular block reversal agent choice: A retrospective cohort study in US hospital setting
An erratum to this article was published (J Clin Anesth, Sep 2024 ↗)
Authors' conclusion
Though this study suggests that neuromuscular block reversal with neostigmine can increase post-operative urinary retention risk
Study context
- Population
- Matched adult inpatients (61,898) and outpatients (95,500) in non-profit, non-governmental community and teaching US hospitals61,898 inpatients
- Exposure
- NMB reversal with neostigmine plus glycopyrrolate vs sugammadex
- Outcome
- Incidence of post-operative urinary retention by NMB reversal agent
Methodological detailsmatched, multicentre healthcare database
- Matched
- Multicentre healthcare database
Main finding
As reported in the abstract
Incidence of post-operative urinary retention
Neostigmine
- Inpatients
- 5.0%
- Outpatients
- 0.9%
Sugammadex
- Inpatients
- 2.4%
- Outpatients
- 0.4%
Inpatients
Neostigmine5.0%
Sugammadex2.4%
Outpatients
Neostigmine0.9%
Sugammadex0.4%
Neostigmine vs SugammadexOdds ratio (95% CI)P value
Inpatients; multivariable logistic regression
2.20(2.00–2.41)
P < 0.001Outpatients; multivariable logistic regression
2.57(2.13–3.10)
P < 0.001- Incidence 2-fold greater with neostigmine plus glycopyrrolate vs sugammadex (inpatients and outpatients)
- P < 0.0001
Observational data: associations, not effects.
Further findings
Post-operative urinary retention-related visits · within 2 days following discharge — Neostigmine with glycopyrrolate vs Sugammadex · inpatients
P = 0.018
| Outcome | P value |
|---|---|
| Post-operative urinary retention-related visits · within 2 days following dischargeNeostigmine with glycopyrrolate vs Sugammadex · outpatients | P < 0.0001 |
Post-operative urinary retention-related visits · within 2 days following discharge
- Five-fold higher with neostigmine
Original publication
Post-operative urinary retention is impacted by neuromuscular block reversal agent choice: A retrospective cohort study in US hospital setting. J Clin Anesth. Published 25 November 2023. doi:10.
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