There is a significant time gap between visual loss of fade and return of TOF ratio >0.90 after reversal of a rocuronium block by neostigmine. Sugammadex in comparison with neostigmine allows a safer reversal of a moderate NMB when relying on visual evaluation of the TOF response.

Sugammadex does not affect level of anesthesia as determined by BIS or entropy levels.

Patients knew the medical qualification of anesthesiologists very well. The work of anesthesiologists was highly appreciated, but the duties outside the operation theatres were poorly known.

Patients with a history of risk factors for stroke and a systolic blood pressure of at least 110 mm Hg were randomly assigned to receive either irbesartan at a target dose of 300 mg once a day or double-blind placebo. The patients were already enrolled in 1 of 2 trials of clopidogrel plus aspirin versus aspirin alone or versus oral anticoagulants. The first coprimary outcome was stroke, myocardial infarction, or death from vascular causes; the second was this composite outcome plus hospitalization for heart failure. Nine thousand sixteen patients were enrolled and followed up for a mean of 4.1 years. The mean reduction in systolic blood pressure was 2.9 mm Hg greater in the irbesartan group than in the placebo group, and the mean reduction in diastolic blood pressure was 1.9 mm Hg greater. The first coprimary outcome happened at a rate of 5.4% per 100 person-years in both groups (hazard ratio with irbesartan, 0.99; 95% confidence interval [CI], 0.91Y1.08). The second coprimary outcome occurred at a rate of 7.3% per 100 person-years among those who received irbesartan and 7.7% per 100 person-years among those who received placebo (hazard ratio, 0.94; 95% CI, 0.87Y1.02). The rates of first hospitalization for heart failure (a prespecified secondary outcome) were 2.7% per 100 person-years among patients who received irbesartan and 3.2% per 100 person-years in those receiving placebo (hazard ratio, 0.86; 95% CI, 0.76Y0.98). Among patients who were in sinus rhythm at baseline, irbesartan was not beneficial in preventing hospitalization for AF or AF recorded on a 12-lead electrocardiogram. There also was no benefit of irbesartan in a subgroup that underwent transtelephonic monitoring. More irbesartan patients than placebo patients had symptomatic hypotension (127 vs 64) and renal dysfunction (43 vs 24). Irbesartan did not lessen cardiovascular events in patients with AF. (Funded by Bristol-Myers Squibb and SanofiAventis; ClinicalTrials.gov no. NCT00249795.)