Efficacy and safety of sugammadex compared to neostigmine for reversal of neuromuscular blockade: a meta-analysis of randomized controlled trials.

摘要: Abstract Background and objective Sugammadex has been introduced for reversal of rocuronium (or vecuronium)–induced neuromuscular blockade (NMB). Although its efficacy established, data are conflicting whether it is safer than neostigmine traditionally used reversing NMB. Design Meta-analysis about effectiveness safety sugammadex compared to NMB in adults was performed using the PRISMA methodology. Setting University medical hospital. Methods A comprehensive search conducted PubMed, Web Science, Cochrane Library electronic databases identify English-language randomized controlled trials. Two reviewers independently selected trials; extracted on times, incomplete reversals NMB, adverse events (AEs); assessed trials' methodological quality evidence level. Only AEs that were related study drug by a blinded assessor considered meta-analysis. Patients total 1384 patients from 13 articles included this Main results Compared neostigmine, faster ( P =.0068). associated with significantly lower likelihood global (OR, 0.47; 95% CI, 0.34-0.66; =.0386), cardiovascular 0.23; 0.08-0.61; =.0036), postoperative weakness 0.45; 0.21-0.97; =.0409). similar nausea vomiting 1.23; 0.70-2.15; =.4719), pain 1.06; 0.15-7.36; =.9559), neurologic 1.47; 0.52-4.17; =.4699), general 0.75; 0.47-1.21; =.2448), changes laboratory tests' values 0.57; 0.18-1.78; =.3368). Conclusions Results meta-analysis suggest superior as reverses more reliably, risk AEs.