Perioperative medicine & outcomes
Sugammadex versus neostigmine for reversal of neuromuscular blockade and postoperative pulmonary complications (SNaPP): an international, randomised, controlled, phase 4 trial
Primary resultResult — go to the resultRelative risk 0.88 95% CI 0.77–1.00Authors' conclusion
Sugammadex reduced the incidence of postoperative pulmonary complications or death compared with neostigmine.
Study context
- Population
- Adults aged ≥40 years having abdominal or thoracic surgery under GA lasting ≥2 h, expected postoperative stay ≥1 night; 44 hospitals in Australia, Aotearoa New Zealand and Hong KongITT population
- Participants
- 3,498 adults
- Comparison
- Sugammadex vs Neostigmine
- Sugammadexn = 1,745
- Neostigminen = 1,753reference
- Primary endpoint
- Postoperative pulmonary complications or death
- Follow-up
- Up to hospital discharge (or postoperative day 7 if still in hospital)
Methodological detailspragmatic, international, multicentre, phase 4, masked outcome assessment, stratified by centre
- Pragmatic
- International
- Multicentre
- Phase 4
- Masked outcome assessment
- Stratified by centre
Primary result
As reported in the abstract
Relative risk
0.88
95% CI 0.77–1.00
P = 0.049
Events by treatment group
Sugammadex vs Neostigmine
RR 0.88 (95% CI 0.77–1.00); P = 0.049
Further findings
| Outcome | Sugammadex | Neostigmine | RR (95% CI) | P value | |
|---|---|---|---|---|---|
| Death | 0.1% | 0.1% | 0.50 (0.05–5.53) | P > 0.99 | |
| Atelectasis | 18.4% | 21.1% | 0.86 (0.76–0.99) | P = 0.030 | |
| Pneumonia | 2.1% | 2.2% | 0.98 (0.62–1.53) | P = 0.92 | |
| Pulmonary aspiration | 0.2% | 0.4% | 0.57 (0.17–1.96) | P = 0.38 | |
| 0.050.21520Relative risk (log scale) |
ARDS
- ARDS not reported
Safety
- No adverse events deemed treatment related
Original publication
Sugammadex versus neostigmine for reversal of neuromuscular blockade and postoperative pulmonary complications (SNaPP): an international, randomised, controlled, phase 4 trial. Lancet Respir Med. Published 9 June 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →