{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T04:16:03Z","timestamp":1782188163156,"version":"3.54.5"},"reference-count":17,"publisher":"Termedia Sp. z.o.o.","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Anaesthesiol Intensive Ther"],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Neostigmine, an acetylcholinesterase inhibitor, is used to reverse the effects of non-depolarizing neuromuscular blocking agents. Inappropriate dosing of neostigmine can lead to post-operative respiratory complications. Post-operative respiratory complications are associated with major morbidity and mortality. The purpose of this case-control study was to determine neuromuscular blockade-related risk factors associated with post-operative respiratory complications (specifically, reintubation, respiratory insufficiency, hypoxia, and\/or aspiration).<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>We performed an Institutional Review Board-approved case-control study of all patients who underwent a\u00a0general anesthetic requiring neuromuscular blockade at Tufts Medical Center between March 22, 2013 and June 1, 2019. Cases were patients who experienced post-operative complications. We identified 58 controls and 116 cases from a\u00a0database of 130,178 patients during the 74-month study period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After adjusting for covariates, the administration of high dose neostigmine (&gt; 60 mg per kg ideal body weight) was associated with increased odds of post-operative respiratory complications (odds ratio = 8.2; 95% CI: 2.5\u201326.6, P &lt; 0.001). Rocuronium dose and the use of train-of-four peripheral nerve stimulator were not associated with post-operative respiratory complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>High dose neostigmine was identified as an independent risk factor for post-operative respiratory complications. Our study suggests that inappropriate dosing of neostigmine continues to be a\u00a0problem despite growing evidence of an association with respiratory complications.<\/jats:p><\/jats:sec>","DOI":"10.5114\/ait.2021.109398","type":"journal-article","created":{"date-parts":[[2021,10,1]],"date-time":"2021-10-01T13:00:40Z","timestamp":1633093240000},"page":"325-328","source":"Crossref","is-referenced-by-count":3,"title":["Identifying high dose neostigmine as a\u00a0risk factor for post-operative respiratory complications: a\u00a0case-control study"],"prefix":"10.5114","volume":"53","author":[{"given":"Shreya","family":"Ranjan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"R. Hall III","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Al-Zarah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sadeq","family":"A. Quraishi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan M.","family":"Drzymalski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3061","published-online":{"date-parts":[[2021,9,28]]},"reference":[{"key":"ref-1378473","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199408000-00020"},{"key":"ref-1378474","doi-asserted-by":"publisher","DOI":"10.1213\/00000539-199204000-00006"},{"key":"ref-1378475","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1177\/000313481307900324","article-title":"The differential effects of intermediate complications with postoperative mortality","volume":"79","author":"Borgi J","year":"2013","unstructured":"Borgi J, Rubinfeld I, Ritz J, Jordan J, Velanovich V. The differential effects of intermediate complications with postoperative mortality. 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