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MINERVA ANESTESIOLOGICA

A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care


Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 2017 March;83(3):248-54

DOI: 10.23736/S0375-9393.16.11489-0

Copyright © 2016 EDIZIONI MINERVA MEDICA

language: English

The effect of routine availability of sugammadex on postoperative respiratory complications: a historical cohort study

Benjamin L. OLESNICKY, Catherine TRAILL, Frank B., MARROQUIN‑HARRIS

Northern Sydney Anesthetic Research Institute, Department of Anesthesia, Royal North Shore Hospital, Sydney, Australia


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BACKGROUND: Postoperative residual curarization is a preventable cause of postoperative morbidity. Although sugammadex has been shown to reduce the risk of residual curarization, it has not yet been shown if this directly translates to a reduction in morbidity. We aimed to demonstrate whether the introduction of unrestricted sugammadex for routine reversal changed the incidence of postoperative respiratory diagnoses and the rate of airway and respiratory complications in the postoperative care unit.
METHODS: A historical cohort study of 1257 patients who underwent general surgical or ear, nose and throat procedures before and after the introduction of unrestricted availability of sugammadex. Patient records were used to identify the incidence of postoperative in-hospital respiratory diagnoses and of airway complications in post-anesthesia care unit, the pattern of muscle relaxant use and the relative costs associated with the routine availability of sugammadex.
RESULTS: Unrestricted sugammadex availability was associated with a significant reduction in the rate of a postoperative in-hospital respiratory diagnosis (odds ratio [OR] 0.20; 95% CI: 0.05-0.72, P=0.01). Furthermore, the use of sugammadex itself was also associated with a reduction in in-hospital respiratory diagnoses (OR=0.26; 95% CI: 0.08-0.94, P=0.04). Unrestricted sugammadex was also associated with a decrease in the need for manual airway support in the recovery room (3.2% vs. 1.1%, P=0.02) and a decrease in patients being transferred intubated to ICU (5.5% vs. 1.3%, P<0.001).
CONCLUSIONS: Unrestricted sugammadex availability is associated with a reduction in postoperative respiratory complications. A well-designed, prospective randomized trial is needed to provide further validation of the data.


KEY WORDS: Cohort studies - Delayed emergence from anesthesia - Humans - Postoperative care - Gamma-cyclodextrins

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Publication History

Issue published online: March 20, 2017
Article first published online: October 5, 2016
Manuscript accepted: October 4, 2016
Manuscript revised: September 13, 2016
Manuscript received: June 17, 2016

Cite this article as

Olesnicky BL, Traill C, Marroquin-Harris FB. The effect of routine availability of sugammadex on postoperative respiratory complications: a historical cohort study. Minerva Anestesiol 2017;83:248-54. DOI: 10.23736/S0375-9393.16.11489-0

Corresponding author e-mail

bolesnicky@hotmail.com