Decurarization After Thoracic Anesthesia using sugammadex compared to neostigmine (DATA trial): a multicenter randomized double-blinded controlled trial
Abstract Background Thoracic surgery is a high-risk surgery especially for the risk of postoperative pulmonary complications. Postoperative residual paralysis has been shown to be a risk factor for pulmonary complications. Nevertheless, there are few data in the literature concerning the use of neur...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-02-01
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| Series: | Journal of Anesthesia, Analgesia and Critical Care |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s44158-024-00146-6 |
| _version_ | 1797272851737214976 |
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| author | Federico Piccioni Giulio L. Rosboch Cecilia Coccia Ilaria Donati Paolo Proto Edoardo Ceraolo Federico Pierconti Martina Pagano Daniele Vernocchi Franco Valenza Giorgio Della Rocca |
| author_facet | Federico Piccioni Giulio L. Rosboch Cecilia Coccia Ilaria Donati Paolo Proto Edoardo Ceraolo Federico Pierconti Martina Pagano Daniele Vernocchi Franco Valenza Giorgio Della Rocca |
| author_sort | Federico Piccioni |
| collection | DOAJ |
| description | Abstract Background Thoracic surgery is a high-risk surgery especially for the risk of postoperative pulmonary complications. Postoperative residual paralysis has been shown to be a risk factor for pulmonary complications. Nevertheless, there are few data in the literature concerning the use of neuromuscular blocking agent antagonists in patients undergoing lung surgery. Methods Seventy patients were randomized in three Italian centers to receive sugammadex or neostigmine at the end of thoracic surgery according to the depth of the residual neuromuscular block. The primary outcome was the time from reversal administration to a train-of-four ratio (TOFR) of 0.9. Secondary outcomes were the time to TOFR of 1.0, to extubation, to postanesthesia unit (PACU) discharge, postoperative complications until 30 days after surgery, and length of hospital stay. Results Median time to recovery to a TOFR of 0.9 was significantly shorter in the sugammadex group compared to the neostigmine one (88 vs. 278 s — P < 0.001). The percentage of patients who recovered to a TOFR of 0.9 within 5 min from reversal administration was 94.4% and 58.8% in the sugammadex and neostigmine groups, respectively (P < 0.001). The time to extubation, but not the PACU stay time, was significantly shorter in the sugammadex group. No differences were found between the study groups as regards postoperative complications and length of hospital stay. The superiority of sugammadex in shortening the recovery time was confirmed for both deep/moderate and shallow/minimal neuromuscular block. Conclusions Among patients undergoing thoracic surgery, sugammadex ensures a faster recovery from the neuromuscular block and earlier extubation compared to neostigmine. |
| first_indexed | 2024-03-07T14:35:20Z |
| format | Article |
| id | doaj.art-cc22562476564fdeb815d9b2b157b760 |
| institution | Directory Open Access Journal |
| issn | 2731-3786 |
| language | English |
| last_indexed | 2024-03-07T14:35:20Z |
| publishDate | 2024-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Anesthesia, Analgesia and Critical Care |
| spelling | doaj.art-cc22562476564fdeb815d9b2b157b7602024-03-05T20:41:51ZengBMCJournal of Anesthesia, Analgesia and Critical Care2731-37862024-02-014111110.1186/s44158-024-00146-6Decurarization After Thoracic Anesthesia using sugammadex compared to neostigmine (DATA trial): a multicenter randomized double-blinded controlled trialFederico Piccioni0Giulio L. Rosboch1Cecilia Coccia2Ilaria Donati3Paolo Proto4Edoardo Ceraolo5Federico Pierconti6Martina Pagano7Daniele Vernocchi8Franco Valenza9Giorgio Della Rocca10Department of Anesthesia and Intensive Care, IRCCS Humanitas Research HospitalAnesthesia and Intensive Care, Dipartimento Di Anestesia, Rianimazione Ed Emergenze AOU Città Della Salute E Della ScienzaAnesthesiology and Intensive Care Unit, IRCCS Regina Elena National Cancer InstituteAnesthesia and Intensive Care Unit, IRCCS Fondazione Istituto Nazionale Dei TumoriAnesthesia and Intensive Care Unit, IRCCS Fondazione Istituto Nazionale Dei TumoriAnesthesia and Intensive Care, Dipartimento Di Anestesia, Rianimazione Ed Emergenze AOU Città Della Salute E Della ScienzaAnesthesiology and Intensive Care Unit, IRCCS Regina Elena National Cancer InstituteSchool of Anesthesia and Intensive Care, University of MilanSchool of Anesthesia and Intensive Care, Humanitas UniversityAnesthesia and Intensive Care Unit, IRCCS Fondazione Istituto Nazionale Dei TumoriDepartment of Medical Area, University of UdineAbstract Background Thoracic surgery is a high-risk surgery especially for the risk of postoperative pulmonary complications. Postoperative residual paralysis has been shown to be a risk factor for pulmonary complications. Nevertheless, there are few data in the literature concerning the use of neuromuscular blocking agent antagonists in patients undergoing lung surgery. Methods Seventy patients were randomized in three Italian centers to receive sugammadex or neostigmine at the end of thoracic surgery according to the depth of the residual neuromuscular block. The primary outcome was the time from reversal administration to a train-of-four ratio (TOFR) of 0.9. Secondary outcomes were the time to TOFR of 1.0, to extubation, to postanesthesia unit (PACU) discharge, postoperative complications until 30 days after surgery, and length of hospital stay. Results Median time to recovery to a TOFR of 0.9 was significantly shorter in the sugammadex group compared to the neostigmine one (88 vs. 278 s — P < 0.001). The percentage of patients who recovered to a TOFR of 0.9 within 5 min from reversal administration was 94.4% and 58.8% in the sugammadex and neostigmine groups, respectively (P < 0.001). The time to extubation, but not the PACU stay time, was significantly shorter in the sugammadex group. No differences were found between the study groups as regards postoperative complications and length of hospital stay. The superiority of sugammadex in shortening the recovery time was confirmed for both deep/moderate and shallow/minimal neuromuscular block. Conclusions Among patients undergoing thoracic surgery, sugammadex ensures a faster recovery from the neuromuscular block and earlier extubation compared to neostigmine.https://doi.org/10.1186/s44158-024-00146-6AnesthesiaNeostigmineNeuromuscular blockadePostoperative complicationsSugammadexThoracic surgery |
| spellingShingle | Federico Piccioni Giulio L. Rosboch Cecilia Coccia Ilaria Donati Paolo Proto Edoardo Ceraolo Federico Pierconti Martina Pagano Daniele Vernocchi Franco Valenza Giorgio Della Rocca Decurarization After Thoracic Anesthesia using sugammadex compared to neostigmine (DATA trial): a multicenter randomized double-blinded controlled trial Journal of Anesthesia, Analgesia and Critical Care Anesthesia Neostigmine Neuromuscular blockade Postoperative complications Sugammadex Thoracic surgery |
| title | Decurarization After Thoracic Anesthesia using sugammadex compared to neostigmine (DATA trial): a multicenter randomized double-blinded controlled trial |
| title_full | Decurarization After Thoracic Anesthesia using sugammadex compared to neostigmine (DATA trial): a multicenter randomized double-blinded controlled trial |
| title_fullStr | Decurarization After Thoracic Anesthesia using sugammadex compared to neostigmine (DATA trial): a multicenter randomized double-blinded controlled trial |
| title_full_unstemmed | Decurarization After Thoracic Anesthesia using sugammadex compared to neostigmine (DATA trial): a multicenter randomized double-blinded controlled trial |
| title_short | Decurarization After Thoracic Anesthesia using sugammadex compared to neostigmine (DATA trial): a multicenter randomized double-blinded controlled trial |
| title_sort | decurarization after thoracic anesthesia using sugammadex compared to neostigmine data trial a multicenter randomized double blinded controlled trial |
| topic | Anesthesia Neostigmine Neuromuscular blockade Postoperative complications Sugammadex Thoracic surgery |
| url | https://doi.org/10.1186/s44158-024-00146-6 |
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