{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T01:19:00Z","timestamp":1768785540275,"version":"3.49.0"},"reference-count":20,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2021,1,21]],"date-time":"2021-01-21T00:00:00Z","timestamp":1611187200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: The harmonization of recovery of consciousness and muscular function is important in emergence from anesthesia. Even if muscular function is recovered, tracheal extubation without adequate recovery of consciousness may increase the risk of respiratory complications. In particular, upper airway obstruction is one of the common respiratory complications and can sometimes be fatal. However, the association between the timing of sugammadex administration and the upper airway obstruction that can occur during awakening from anesthesia has rarely been studied. Materials and Methods: The medical records of 456 patients who had surgery under general endotracheal anesthesia (GETA) at the Haeundae Paik Hospital between October 2017 and July 2018 and who received intravenous sugammadex to reverse rocuronium-induced neuromuscular blockade were analyzed. The correlations between bispectral index (BIS) and minimum alveolar concentration (MAC) at the time of sugammadex administration, the incidence of complications, and the time to tracheal extubation were analyzed to investigate how different timings of sugammadex administration affected upper airway obstruction after tracheal extubation. Conclusions: The effect of BIS and the duration from anesthetic discontinuation to sugammadex administration on upper airway obstruction was not statistically significant. However, the odds ratio of complication rates with MAC &lt; 0.3 compared with MAC \u2265 0.3 was 0.40 (95% confidence interval 0.20 to 0.81, p = 0.011), showing a statistically significant increase in risk with MAC \u2265 0.3 for upper airway obstruction.<\/jats:p>","DOI":"10.3390\/medicina57020088","type":"journal-article","created":{"date-parts":[[2021,1,21]],"date-time":"2021-01-21T02:36:05Z","timestamp":1611196565000},"page":"88","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The Relationship between the Timing of Sugammadex Administration and the Upper Airway Obstruction during Awakening from Anesthesia: A Retrospective Study"],"prefix":"10.3390","volume":"57","author":[{"given":"Eunsu","family":"Kang","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Haeundae Paik Hospital of Inje University, 875 Haeun-daero, Haeundae-gu, Busan KS012, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Byeong Cheol","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Haeundae Paik Hospital of Inje University, 875 Haeun-daero, Haeundae-gu, Busan KS012, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jae Hong","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Haeundae Paik Hospital of Inje University, 875 Haeun-daero, Haeundae-gu, Busan KS012, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sang Eun","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Haeundae Paik Hospital of Inje University, 875 Haeun-daero, Haeundae-gu, Busan KS012, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Se Hun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Haeundae Paik Hospital of Inje University, 875 Haeun-daero, Haeundae-gu, Busan KS012, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8064-9904","authenticated-orcid":false,"given":"Daeseok","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Haeundae Paik Hospital of Inje University, 875 Haeun-daero, Haeundae-gu, Busan KS012, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dae Yun","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Haeundae Paik Hospital of Inje University, 875 Haeun-daero, Haeundae-gu, Busan KS012, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Myoung Jin","family":"Ko","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Haeundae Paik Hospital of Inje University, 875 Haeun-daero, Haeundae-gu, Busan KS012, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,1,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1007\/s11096-013-9749-0","article-title":"Timing is important in medication administration: A timely review of chronotherapy research","volume":"35","author":"Kaur","year":"2013","journal-title":"Int. J. Clin. Pharm."},{"key":"ref_2","first-page":"816","article-title":"Reversal of profound rocuronium-induced blockade with sugammadexa randomized comparison with neostigmine","volume":"109","author":"Jones","year":"2008","journal-title":"Anesthesiol. J. Am. Soc. Anesthesiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1002\/lary.25577","article-title":"Reversal of rocuronium-induced neuromuscular blockade by sugammadex allows for optimization of neural monitoring of the recurrent laryngeal nerve","volume":"126","author":"Lu","year":"2016","journal-title":"Laryngoscope"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1016\/j.anclin.2010.07.003","article-title":"Anesthesia, sleep, and upper airway collapsibility","volume":"28","author":"Hillman","year":"2010","journal-title":"Anesthesiol. Clin."},{"key":"ref_5","first-page":"441","article-title":"Extubation in adult patients: Who, what, when, where, how, and why?","volume":"11","author":"Kempen","year":"1999","journal-title":"J. Clin. Anesth."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"350","DOI":"10.3889\/oamjms.2018.083","article-title":"Survey about the extubation practice among anaesthesiologists in kosovo","volume":"6","author":"Baftiu","year":"2018","journal-title":"Open Access Maced. J. Med. Sci."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1097\/EJA.0000000000000454","article-title":"Relationship between timing of sugammadex administration and development of laryngospasm during recovery from anaesthesia when using supraglottic devices: A randomised clinical study","volume":"33","author":"Komasawa","year":"2016","journal-title":"Eur. J. Anaesthesiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1997","DOI":"10.12688\/f1000research.13064.1","article-title":"The impact of fresh gas flow on wash-in, wash-out time and gas consumption for sevoflurane and desflurane, comparing two anaesthesia machines, a test-lung study","volume":"6","author":"Leijonhufvud","year":"2017","journal-title":"F1000Research"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1007\/s10877-006-9044-x","article-title":"Using EEG to monitor anesthesia drug effects during surgery","volume":"20","author":"Jameson","year":"2006","journal-title":"J. Clin. Monit. Comput."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1213\/01.ANE.0000072741.78244.C0","article-title":"The bispectral index declines during neuromuscular block in fully awake persons","volume":"97","author":"Messner","year":"2003","journal-title":"Anesth. Analg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1093\/bja\/aep198","article-title":"Time delay of electroencephalogram index calculation: Analysis of cerebral state, bispectral, and Narcotrend indices using perioperatively recorded electroencephalographic signals","volume":"103","author":"Zanner","year":"2009","journal-title":"Br. J. Anaesth."},{"key":"ref_12","first-page":"756","article-title":"Minimum Alveolar Anesthetic ConcentrationA Standard of Anesthetic Potency","volume":"26","author":"Eger","year":"1965","journal-title":"Anesthesiol. J. Am. Soc. Anesthesiol."},{"key":"ref_13","first-page":"5","article-title":"Minimum Alveolar Concentrations in Man on Awakening from Methoxyflurane, Halothane, Ether and Fluroxene AnesthesiaMAC Awake","volume":"33","author":"Stoelting","year":"1970","journal-title":"Anesthesiol. J. Am. Soc. Anesthesiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1111\/anae.12168","article-title":"Minimum alveolar concentration: Ongoing relevance and clinical utility","volume":"68","author":"Aranake","year":"2013","journal-title":"Anaesthesia"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1093\/bja\/76.2.179","article-title":"Effect of age on MAC in humans: A meta-analysis","volume":"76","author":"Mapleson","year":"1996","journal-title":"Br. J. Anaesth."},{"key":"ref_16","first-page":"384","article-title":"MAC ExpandedAD50 and AD95 Values of Common Inhalation Anesthetics in Man","volume":"42","author":"Eger","year":"1975","journal-title":"Anesthesiol. J. Am. Soc. Anesthesiol."},{"key":"ref_17","first-page":"315","article-title":"Determination and applications of MAC","volume":"53","author":"Quasha","year":"1980","journal-title":"Anesthesiol. J. Am. Soc. Anesthesiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1489","DOI":"10.1097\/00000539-200112000-00029","article-title":"The recovery of cognitive function after general anesthesia in elderly patients: A comparison of desflurane and sevoflurane","volume":"93","author":"Chen","year":"2001","journal-title":"Anesth. Analg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1111\/aas.12435","article-title":"Emergence agitation after orthognathic surgery: A randomised controlled comparison between sevoflurane and desflurane","volume":"59","author":"Choi","year":"2015","journal-title":"Acta Anaesthesiol. Scand."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e4927","DOI":"10.1097\/MD.0000000000004927","article-title":"Comparison of the incidence of emergence agitation and emergence times between desflurane and sevoflurane anesthesia in children: A systematic review and meta-analysis","volume":"95","author":"Lim","year":"2016","journal-title":"Medicine"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/57\/2\/88\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:13:20Z","timestamp":1760159600000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/57\/2\/88"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,21]]},"references-count":20,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2021,2]]}},"alternative-id":["medicina57020088"],"URL":"https:\/\/doi.org\/10.3390\/medicina57020088","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,21]]}}}