The effect of sugammadex on postoperative urinary retention and recovery characteristics: a systematic review and meta-analysis.

BACKGROUND

Postoperative urinary retention (POUR) is a frequent complication following general anesthesia. There is growing interest in whether sugammadex, a neuromuscular blockade (NMB) reversal agent that does not require anticholinergic coadministration, might reduce its incidence. This systematic review and meta-analysis aimed to evaluate the effects of sugammadex on POUR and other postoperative recovery outcomes, such as 30-day readmission rates and postoperative pain scores (POPS).

METHODS

PubMed, Cochrane, Embase, and Web of Science were comprehensively searched for studies published through June 3, 2024. Randomized controlled trials (RCTs) and cohort studies comparing sugammadex with conventional reversal agents or no reversal agents were included. Meta-analysis was performed using Stata 15.1 to synthesize the results.

RESULTS

The analysis ultimately included 25 studies involving a total of 163,367 patients: 84,362 received sugammadex, while 79,005 received neostigmine, or did not receive an antagonist.Meta-analysis revealed a significant reduction in the incidence of POUR with sugammadex use (Relative Risk (RR): 0.47, 95% Confidence Interval (CI): 0.34-0.64, P < 0.001). No meaningful differences were observed in POPS (Standardized Mean Difference (SMD): -0.01, 95% CI: -0.43-0.40, P = 0.945) or 30-day readmission rates (RR: 0.81, 95% CI: 0.65-1.01, P = 0.057).

CONCLUSION

These findings suggest that sugammadex substantially reduces POUR incidence, with no significant impact on POPS or 30-day readmission rates. Further research is warranted to explore its role in diverse patient populations and surgical procedures and to investigate its potential influence on postoperative pain management and readmission rates.