Sugammadex reversal of muscle relaxant blockade provided less Post-Anesthesia Care Unit adverse effects than neostigmine/glycopyrrolate

Sugammadex is a direct reversal agent of aminosteroid muscle relaxants, particularly rocuronium, with promptly and completely reverse of deep neuromuscular block (NMB), which allows better surgical conditions. Sugammadex exhibits advantages over indirect reversal agent acetylcholinesterase inhibitor neostigmine with less adverse effects. In this retrospective review, we compared the incidence of postoperative vomiting (POV), postoperative urinary retention (POUR), and hemodynamic changes between sugammadex and neostigmine/glycopyrrolate in reversal of muscular blockade. Sugammadex showed superior in all three aspects. The heart rate was 7.253 lower (P < 0.0001) and mean arterial pressure was 5.213 lower (P < 0.0001) in sugammadex group. The POV of neostigmine/glycopyrrolate group was 3.16 times more than sugammadex group (OR Z 3.16, p < 0.0001), and POUR of neostigmine/glycopyrrolate group was 4.291 times more than sugammadex group (OR Z 4.291, p < 0.0001). Sugammadex showed better hemodynamic stability, and lower incidence of POV and POUR than neostigmine/glycopyrrolate. Copyright (c) 2022, Formosan Medical Association. Published by Elsevier Taiwan LLC. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

Automated summary

Sugammadex is a direct reversal agent that effectively reverses deep neuromuscular block caused by muscle relaxants. Compared to neostigmine, it exhibits better reversal effects with fewer adverse effects. This retrospective review shows that sugammadex performs better than neostigmine/glycopyrrolate in terms of postoperative vomiting, postoperative urinary retention, and hemodynamic stability.