Efficacy and Safety of Neuromuscular Blockade in Overweight Patients Undergoing Nasopharyngeal Surgery

2023 American Society of Anesthesiologists Practice Guidelines for Monitoring and Antagonism of Neuromuscular Blockade: A Report by the American Society of Anesthesiologists Task Force on Neuromuscular Blockade

“…S15, http://links.lww.com/ALN/C929). 66,82,99,102–104 A pooled estimate from seven nonrandomized studies also did not detect a difference in pulmonary complications (very low strength of evidence). 45,93,105–109 Five randomized controlled trials 59,61,66,104,110 and four cohort studies 93,106,108,109 reported fewer episodes of pneumonia with sugammadex than neostigmine (low to very low strength of evidence; supplemental fig.…”

“…S13, http://links.lww.com/ALN/C929). 61,68,69,74,95,98 Differences were also not detected for arrhythmias irrespective of antimuscarinic used 89,95,99–101 (low strength of evidence; supplemental fig. S14, http://links.lww.com/ALN/C929; table S22, http://links.lww.com/ALN/C928).…”

“…S19, http://links.lww.com/ALN/C929, risk difference for sugammadex versus neostigmine of ˗2.9% [95% CI, ˗8.5 to 2.7]; low strength of evidence). 65,68,70,72,73,81,86–88,90,99,118,119…”

“…The body of evidence enrolling adults included 191 studies (133 randomized controlled trials, 4,92,95,[98][99][100][101][102][103][104][110][111][112][113][114][118][119][120][121][122][123][124][125][126][127][132][133][134][135][136][137][138][139][140][141][145][146][147][148][155][156][157]163,[173][174][175][176][177][178][179][180][181] 11 nonrandomized trials, …”

“…The incidence of reparalysis was variable across trials not occurring with either neostigmine or sugammadex in 10 of 13 randomized trials (supplemental fig. S19, http://links.lww.com/ALN/C929, risk difference for sugammadex versus neostigmine of ˗2.9% [95% CI, ˗8.5 to 2.7]; low strength of evidence).65,68,70,72,73,81,[86][87][88]90,99,118,119 …”