Postoperative oxygenation assessed by SpO2/FiO2 ratio and respiratory complications after reversal of neuromuscular block with Sugammadex or neostigmine: A retrospective cohort study
Main finding · Minimum SpO2/FiO2 ratioResult — go to the resultDifference in means −3.5 95% CI −5.3 to −1.7Authors' conclusion
Postoperative minimum SpO2/FiO2 ratio during PACU admission was similar after reversal of neuromuscular block by sugammadex and neostigmine. Reversal with sugammadex was associated with more pulmonary complications, but most were minor and of little consequence.
Study context
- Population
- Adults after non-cardiothoracic surgery given neostigmine or sugammadex, PACU of a tertiary care hospital
- Participants
- 71,457 cases
- Exposure
- Sugammadex vs neostigmine for reversal of NMB
- Sugammadexn = 10,708
- Neostigminen = 60,749reference
- Outcome
- Lowest SpO2/FiO2 ratio in the PACU
Methodological detailspropensity weighting, single tertiary care hospital
- Propensity weighting
- Single tertiary care hospital
Main finding
Minimum SpO2/FiO2 ratio
Difference in means
−3.5
95% CI −5.3 to −1.7
P = 0.0002
By group
Sugammadex
301
mean · SD 77
Neostigmine
303
mean · SD 71
Sugammadex vs Neostigmine
difference in means −3.5 (95% CI −5.3 to −1.7); P = 0.0002
As reported in the abstract
Observational data: associations, not effects.
Safety
Composite postoperative pulmonary complications · secondary outcome
number-needed-to-be-exposed 136 (83–330) · P = 0.0005
Composite postoperative pulmonary complications
- Main contributing components: new bronchospasm or exacerbation of obstructive pulmonary disease
Original publication
Postoperative oxygenation assessed by SpO2/FiO2 ratio and respiratory complications after reversal of neuromuscular block with Sugammadex or neostigmine: A retrospective cohort study. J Clin Anesth. Published 5 May 2023. doi:10.
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