{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T21:18:56Z","timestamp":1788211136868,"version":"build-2803163510"},"reference-count":40,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,12,23]],"date-time":"2022-12-23T00:00:00Z","timestamp":1671753600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009947","name":"Merck Sharp and Dohme","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009947","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>Reversing neuromuscular blockade with sugammadex can eliminate residual paralysis, which has been associated with postoperative respiratory complications. There are equivocal data on whether sugammadex reduces these when compared with neostigmine. We investigated the association of the choice of reversal drug with postoperative respiratory complications and advanced healthcare utilisation. We included adult patients who underwent surgery and received general anaesthesia with sugammadex or neostigmine reversal at two academic healthcare networks between January 2016 and June 2021. The primary outcome was postoperative respiratory complications, defined as post\u2010extubation oxygen saturation &lt;\u200990%, respiratory failure requiring non\u2010invasive ventilation, or tracheal re\u2010intubation within 7\u2009days. Our main secondary outcome was advanced healthcare utilisation, a composite outcome including: 7\u2010day unplanned intensive care unit admission; 30\u2010day hospital readmission; or non\u2010home discharge. In total, 5746 (6.9%) of 83,250 included patients experienced postoperative respiratory complications. This was not associated with the reversal drug (adjusted OR (95%CI) 1.01 (0.94\u20131.08); p\u00a0=\u00a00.76). After excluding patients admitted from skilled nursing facilities, 8372 (10.5%) patients required advanced healthcare utilisation, which was not associated with the choice of reversal (adjusted OR (95%CI) 0.95 (0.89\u20131.01); p\u00a0=\u00a00.11). Equivalence testing supported an equivalent effect size of sugammadex and neostigmine on both outcomes, and neostigmine was non\u2010inferior to sugammadex with regard to postoperative respiratory complications or advanced healthcare utilisation. Finally, there was no association between the reversal drug and major adverse cardiovascular events (adjusted OR 1.07 (0.94\u20131.21); p\u00a0=\u00a00.32). Compared with neostigmine, reversal of neuromuscular blockade with sugammadex was not associated with a reduction in postoperative respiratory complications or post\u2010procedural advanced healthcare utilisation.<\/jats:p>","DOI":"10.1111\/anae.15940","type":"journal-article","created":{"date-parts":[[2022,12,23]],"date-time":"2022-12-23T03:39:50Z","timestamp":1671766790000},"page":"294-302","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["The effects of sugammadex vs. neostigmine on postoperative respiratory complications and advanced healthcare utilisation: a multicentre retrospective cohort study"],"prefix":"10.1111","volume":"78","author":[{"given":"A.","family":"Suleiman","sequence":"first","affiliation":[{"name":"Department of Anesthesia, Critical Care and Pain Medicine, Center for Anesthesia Research Excellence (CARE) Beth Israel Deaconess Medical Center, Harvard Medical School  MA Boston USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Munoz\u2010Acuna","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Critical Care and Pain Medicine, Center for Anesthesia Research Excellence (CARE) Beth Israel Deaconess Medical Center, Harvard Medical School  MA Boston USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O.","family":"Azimaraghi","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Montefiore Medical Center and Albert Einstein College of Medicine  NY Bronx USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. T.","family":"Houle","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Critical Care and Pain Medicine Massachusetts General Hospital, Harvard Medical School  MA Boston USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Critical Care and Pain Medicine, Center for Anesthesia Research Excellence (CARE) Beth Israel Deaconess Medical Center, Harvard Medical School  MA Boston USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Rupp","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Montefiore Medical Center and Albert Einstein College of Medicine  NY Bronx USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. S.","family":"Witt","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Montefiore Medical Center and Albert Einstein College of Medicine  NY Bronx USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. A.","family":"Azizi","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Critical Care and Pain Medicine, Center for Anesthesia Research Excellence (CARE) Beth Israel Deaconess Medical Center, Harvard Medical School  MA Boston USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Ahrens","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Critical Care and Pain Medicine, Center for Anesthesia Research Excellence (CARE) Beth Israel Deaconess Medical Center, Harvard Medical School  MA Boston USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Shay","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Harvard T.H. Chan School of Public Health  MA Boston USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Wongtangman","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Montefiore Medical Center and Albert Einstein College of Medicine  NY Bronx USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. J.","family":"Wachtendorf","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Critical Care and Pain Medicine, Center for Anesthesia Research Excellence (CARE) Beth Israel Deaconess Medical Center, Harvard Medical School  MA Boston USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. 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