Reversal effect of sugammadex sodium on rocuronium-induced neuromuscular blockade in patients undergoing painless tracheoscopy.

OBJECTIVE

To compare the efficacy and safety of sugammadex sodium versus neostigmine for rocuronium-induced neuromuscular blockade during painless tracheoscopy.

METHODS

A retrospective analysis was conducted in 278 consecutive patients who underwent painless tracheoscopy under rocuronium anesthesia between January 2023 and May 2024. Patients received either sugammadex (n = 125) or neostigmine (n = 153) for muscle-relaxant reversal. Outcomes evaluated included train-of-four (TOF) recovery times (TOF ≥ 0.25, 0.75, 0.9), complete reversal rates, recovery metrics (eye-opening time, post-anesthesia care unit (PACU) stay) and complication rates. Correlations between baseline characteristics and TOF recovery times were also assessed.

RESULTS

Sugammadex significantly accelerated TOF recovery (all P < 0.001) and improved complete reversal rate (P = 0.013). Eye-opening and PACU times were reduced by 35.4% and 35.8%, respectively (both P < 0.001). The incidences of hypoxemia, bradycardia, and postoperative nausea and vomiting (PONV) were also decreased (all P < 0.05). Age, body mass index (BMI), and American Society of Anesthesiologists (ASA) class were positively correlated with TOF recovery time.

CONCLUSION

In painless tracheoscopy, sugammadex sodium provides rapid and complete reversal of rocuronium, lowers postoperative complications, and improves perioperative efficiency.