{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T01:31:00Z","timestamp":1777944660390,"version":"3.51.4"},"reference-count":40,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T00:00:00Z","timestamp":1762128000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T00:00:00Z","timestamp":1762128000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Perioperative Practice"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Sugammadex is a relatively new therapeutic agent that reverses neuromuscular blockade. Compared to neostigmine, it is hypothesised that sugammadex could have a beneficial effect on postoperative cognitive function, benefitting postoperative recovery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To compare the effects of both sugammadex and neostigmine on delirium and postoperative cognitive dysfunction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A systematic search of all relevant randomised controlled trials and observational cohort studies was performed in October 2024, utilising the following inclusion criteria: incidence of delirium and postoperative cognitive dysfunction following administration of neostigmine or sugammadex, adult patients, patients given rocuronium or vecuronium, English language studies, papers since the introduction of sugammadex (2008). CASP and Cochrane risk-of-bias tools were utilised for study appraisal, with a narrative synthesis of the results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Five studies, reporting interventions in 49,910 patients, met the review criteria and were included. Of these, four showed no difference in cognitive function between sugammadex and neostigmine. One cohort study of 21 patients showed favourable outcomes postoperatively in the sugammadex group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This systematic review suggests the possibility of a very limited neurological protective role of sugammadex compared to neostigmine, but no clinical significance was reported. Only a limited number of studies were available, suggesting the need for further research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17504589251379195","type":"journal-article","created":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T13:11:23Z","timestamp":1762175483000},"page":"314-325","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparing sugammadex to neostigmine and their effects on delirium and postoperative cognitive function: A systematic review"],"prefix":"10.1177","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-2876-822X","authenticated-orcid":false,"given":"Andrew","family":"Slowgrove","sequence":"first","affiliation":[{"name":"Warwick Medical School, University of Warwick, Coventry, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8506-6433","authenticated-orcid":false,"given":"Celeste","family":"Ng","sequence":"additional","affiliation":[{"name":"Warwick Medical School, University of Warwick, Coventry, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3753-0411","authenticated-orcid":false,"given":"Alexandra","family":"Tebbett","sequence":"additional","affiliation":[{"name":"Warwick Medical School, University of Warwick, Coventry, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,11,3]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/aas.12389"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/0310057X1704500508"},{"key":"e_1_3_3_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anclin.2015.05.008"},{"key":"e_1_3_3_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13030861"},{"key":"e_1_3_3_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.15094"},{"issue":"7","key":"e_1_3_3_7_1","article-title":"Economic burden of postoperative neurocognitive disorders among US Medicare patients","volume":"3","author":"Boone M","year":"2020","unstructured":"Boone M, Sites B, von Recklinghausen F, et al 2020 Economic burden of postoperative neurocognitive disorders among US Medicare patients Journal of the American Medical Association Network Open 3 (7) e208931","journal-title":"Journal of the American Medical Association Network Open"},{"issue":"2","key":"e_1_3_3_8_1","first-page":"75","article-title":"Postoperative cognitive dysfunction in clinical practice","volume":"21","author":"Brodier E","year":"2021","unstructured":"Brodier E, Cibelli M 2021 Postoperative cognitive dysfunction in clinical practice British Journal of Anaesthesia Education 21 (2) 75\u201382","journal-title":"British Journal of Anaesthesia Education"},{"key":"e_1_3_3_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cccb.2021.100017"},{"key":"e_1_3_3_10_1","unstructured":"CASP 2023a CASP randomised controlled trial checklist. critical appraisal skills programme [Online] Available from: https:\/\/casp-uk.net\/casp-tools-checklists\/randomised-controlled-trial-rct-checklist\/ [Accessed October 2024]"},{"key":"e_1_3_3_11_1","unstructured":"CASP 2023b CASP Cohort Study Checklist. 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