Facultad de Enfermería y Fisioterapia Salus Infirmorum

Randomised controlled trial of sugammadex or neostigmine for reversal of neuromuscular block on the incidence of pulmonary complications in older adults undergoing prolonged surgery / (Record no. 15051)

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007 - PHYSICAL DESCRIPTION FIXED FIELD--GENERAL INFORMATION
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International Standard Serial Number 0007-0912
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Transcribing agency Salus Infirmorum
245 00 - TITLE STATEMENT
Title Randomised controlled trial of sugammadex or neostigmine for reversal of neuromuscular block on the incidence of pulmonary complications in older adults undergoing prolonged surgery /<br/>
Statement of responsibility, etc. Brandon M. Togioka, David Yanez, Michael F. Aziz, Janna R. Higgins, Praveen Tekkali and Miriam M. Treggiari
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Extent 448kb
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Bibliography, etc. note Bibliografía: p.560-561
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Summary, etc. Background: Residual neuromuscular block has been associated with postoperative pulmonary complications. We hypothesised that sugammadex reduces postoperative pulmonary complications in patients aged �70 yr having surgery�3 h, compared with neostigmine.<br/>Methods: Patients were enrolled in an open-label, assessor-blinded, randomised, controlled trial. At surgical closure, subjects were equally randomised to receive sugammadex 2 mg kg�1 or neostigmine 0.07 mg kg�1 (maximum 5 mg) for rocuronium reversal. The primary endpoint was incidence of postoperative pulmonary complications. Secondary end-points included residual paralysis (train-of-four ratio <0.9 in the PACU) and Phase 1 recovery (time to attain pain control and stable respiratory, haemodynamic, and neurological status). The analysis was by intention-to-treat.<br/>Results: Of the 200 subjects randomised, 98 received sugammadex and 99 received neostigmine. There was no significant difference in the primary endpoint of postoperative pulmonary complications despite a signal towards reduced incidence for sugammadex (33% vs 40%; odds ratio [OR]¼0.74; 95% confidence interval [CI]¼[0.40, 1.37]; P¼0.30) compared with neostigmine. Sugammadex decreased residual neuromuscular block (10% vs 49%; OR¼0.11, 95% CI¼[0.04, 0.25]; P<0.001).<br/>Phase 1 recovery time was comparable between sugammadex (97.3 min [standard deviation, SD¼54.3]) and neostigmine (110.0 min [SD¼62.0]), difference e12.7 min (95% CI, [e29.2, 3.9], P¼0.13). In an exploratory analysis, there were fewer 30 day hospital readmissions in the sugammadex group compared with the neostigmine group (5% vs 15%; OR¼0.30, 95% CI¼[0.08, 0.91]; P¼0.03).<br/>Conclusions: In older adults undergoing prolonged surgery, sugammadex was associated with a 40% reduction in re-sidual neuromuscular block, a 10% reduction in 30 day hospital readmission rate, but no difference in the occurrence ofpostoperative pulmonary complications. Based on this exploratory study, larger studies should determine whether sugammadex may reduce postoperative pulmonary complications and 30 day hospital readmissions.<br/>Clinical trial registration: NCT02861131.
653 14 - INDEX TERM--UNCONTROLLED
Uncontrolled term acetylcholinesterase inhibitor
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Uncontrolled term cyclodextrin
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Uncontrolled term neostigmine
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Uncontrolled term neuromuscular block
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Uncontrolled term pulmonary complications
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Uncontrolled term rocuronium
653 14 - INDEX TERM--UNCONTROLLED
Uncontrolled term sugammadex
773 ## - HOST ITEM ENTRY
Related parts -- 2020 v. 124, n.5, p.553-561
Title British Journal of Anaesthesia
942 ## - ADDED ENTRY ELEMENTS (KOHA)
Source of classification or shelving scheme Universal Decimal Classification
Koha item type Artículo de revista
Holdings
Withdrawn status Lost status Source of classification or shelving scheme Damaged status Not for loan Collection code Home library Current library Date acquired Total Checkouts Full call number Barcode Date last seen Price effective from Koha item type
    Universal Decimal Classification     Non-fiction Revistas y artículos Revistas y artículos 27/04/2023   PP 6027 27/04/2023 27/04/2023 Artículo de revista

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