Background And Aims: The use of sugammadex instead of neostigmine for the reversal of neuromuscular blockade may decrease postoperative pulmonary complications. It is unclear if this finding is applicable to situations where sugammadex is administered after the administration of neostigmine. The objective of this study was to compare the incidence of a composite outcome measure of major postoperative pulmonary complications in patients who received sugammadex as a rescue agent after neostigmine versus those who received sugammadex alone for reversal of neuromuscular blockade.
Material And Methods: This retrospective cohort study analyzed the medical records of adult patients who underwent elective inpatient noncardiac surgery under general anesthesia and received sugammadex for reversal of neuromuscular blockade, at a tertiary care academic hospital between August 2016 and November 2018.
Results: A total of 1,672 patients were included, of whom 1,452 underwent reversal with sugammadex alone and 220 received sugammadex following reversal with neostigmine/glycopyrrolate. The composite primary outcome was diagnosed in 60 (3.6%) patients. Comparing these two groups, and after adjusting for confounding factors, patients who received sugammadex after reversal with neostigmine had more postoperative pulmonary complications than those reversed with sugammadex alone (6.8% vs. 3.1%, odds ratio, 2.29; 95% confidence interval [CI], 1.25 to 4.18; = 0.006).
Conclusion: The use of sugammadex following reversal with neostigmine was associated with a higher incidence of postoperative pulmonary complications as compared to the use of sugammadex alone. The implications of using sugammadex after the failure of standard reversal drugs should be investigated in prospective studies.
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http://dx.doi.org/10.4103/joacp.joacp_289_21 | DOI Listing |
Multimed Man Cardiothorac Surg
January 2025
New Cross Hospital, Royal Wolverhampton NHS Trust, Wolverhampton, United Kingdom.
Robotic-assisted thoracic surgery has become increasingly utilized in recent years. Complex lung cancer resection surgery can be performed using a robotic approach. It facilitates 3-dimentional visualization of structures, enhanced manipulation of tissues and precise movements.
View Article and Find Full Text PDFJ Contemp Dent Pract
September 2024
Department of Periodontology, Narsinhbhai Patel Dental College and Hospital, Sankalchand Patel University, Visnagar, Gujarat, India.
Aim: This study aims to evaluate the impact of platelet-rich fibrin (PRF) and platelet-rich plasma (PRP) on pain, swelling, trismus, soft tissue healing and bone regeneration following mandibular third molar extraction.
Material And Methods: A systematic review was conducted from a period of January 2014 to June 2024 using PRISMA guidelines. The search strategy included databases such as Scopus, PubMed, Google Scholar, and Cochrane Central Register of Controlled Trials, using key terms related to "PRF", "PRP", oral surgery, and third molars.
Dis Esophagus
January 2025
Department of Surgery, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland.
Enhanced Recovery After Surgery (ERAS) protocols are evidence-based care improvement pathways which are perceived to expedite patient recovery following surgery. Their utility in the setting of oesophagectomy remains unclear. The aim of this study was to perform a systematic review and meta-analysis of randomised clinical trials (RCTs) to evaluate the impact of ERAS protocols on recovery following oesophagectomy compared to standard care.
View Article and Find Full Text PDFAnn Thorac Surg Short Rep
December 2024
Department of Thoracic Surgery, The University of Tokyo Hospital, Tokyo, Japan.
The patient was a 66-year-old man who developed exacerbation of respiratory and heart failure that necessitated tracheal intubation. The exacerbation was considered to be largely caused by asthma-chronic obstructive pulmonary disease overlap syndrome and type 3 pulmonary hypertension. However, left diaphragmatic eventration and tracheal stenosis were also found.
View Article and Find Full Text PDFAnn Thorac Surg Short Rep
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Department of Thoracic Surgery and Oncology, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China.
The subsuperior segment (S∗), as an atypical pulmonary segment, is located between the superior and posterior basal segments. Many thoracic surgeons have no experience with anatomical segmental resection of S∗. We present a case of the posterior approach of left S∗ segmentectomy.
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