Anaesthetic drugs & techniques
Sugammadex vs. neostigmine and the risk of postoperative pulmonary complications after upper gastrointestinal endoscopic procedures: a propensity score matched analysis of 15,730 patients
Main findingResult — go to the resultRelative risk 1.49 95% CI 1.30–1.72Authors' conclusion
In this large cohort of adults undergoing upper gastrointestinal endoscopy, sugammadex use was associated with important reductions in tracheal extubation failure, lung atelectasis or collapse, and unplanned ICU admission compared with neostigmine, including in those patients without known chronic pulmonary disease.
Study context
- Population
- Adults undergoing upper gastrointestinal endoscopy under GA who received rocuroniumafter matching
- Participants
- 15,730 adults
- Exposure
- Sugammadex vs neostigmine for antagonism of rocuronium-induced NMB
- Sugammadexn = 7,865
- Neostigminen = 7,865reference
- Outcome
- Failure of tracheal extubation (postoperative ventilator dependence or tracheal reintubation)
- Follow-up
- Within 30 days
Methodological detailsmulticentre, propensity score matched, federated health record network, prespecified subgroup analysis
- Multicentre
- Propensity score matched
- Federated health record network
- Prespecified subgroup analysis
Main finding
As reported in the abstract
Relative risk
1.49
95% CI 1.30–1.72
P < 0.0001
Events by group
- Absolute risk reduction
- 1.91%
- NNT
- 52
Observational data: associations, not effects.
Secondary outcomes
Lung atelectasis or collapse
P = 0.014
Unplanned ICU admission
P = 0.009
Failure of tracheal extubation (subgroup without chronic pulmonary disease, 4624 patient pairs) · prespecified subgroup analysis
P < 0.001
Unplanned ICU admission (subgroup without chronic pulmonary disease, 4624 patient pairs) · prespecified subgroup analysis
P < 0.001
Original publication
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