Sugammadex Versus Neostigmine for Reversal of Neuromuscular Blockade in Patients With Severe Renal Impairment: A Randomized, Double-Blinded Study
Primary result · Time to recovery of TOFR ≥90%Result — go to the resultMean difference 11.3 minutes 95% CI 9.0–13.5Authors' conclusion
In patients with severe renal impairment, neuromuscular blockade with rocuronium followed by reversal with sugammadex provides a significantly faster return of neuromuscular function compared to cisatracurium and neostigmine, without any major adverse effects.
Study context
- Population
- Adults, American Society of Anesthesiologists (ASA) III–IV, creatinine clearance <30 mL/min, GA with expected surgery ≥2 hours requiring NMBenrolled
- Participants
- 49 adults
- Comparison
- Neostigmine vs Sugammadex
- Primary endpoint
- Time from reversal administration to train-of-four ratio (TOFR) ≥90% (electromyography)
Methodological detailsprospective, blinded, double-blinded, single-centre
- Prospective
- Blinded
- Double-blinded
- Single-centre
Primary result
Time to recovery of TOFR ≥90%
Mean difference
11.3 minutes
95% CI 9.0–13.5
P < 0.0001
By group
Neostigmine vs Sugammadex
mean difference 11.3 minutes (95% CI 9.0–13.5); P < 0.0001
As reported in the abstract
Safety
Events
| Outcome | Sugammadex | Neostigmine |
|---|---|---|
| Major adverse events | 0 | 0 |
Original publication
Sugammadex Versus Neostigmine for Reversal of Neuromuscular Blockade in Patients With Severe Renal Impairment: A Randomized, Double-Blinded Study. Anesth Analg. Published 8 January 2024. doi:10.
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