Hernia : the journal of hernias and abdominal wall surgery · 2026
Effect of neuromuscular blockade reversal strategy on gastrointestinal recovery following abdominal wall reconstruction: a randomized controlled trial.
СтатьяРандомизированное исследованиеНазвание и аннотация: Перевод в очереди
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Remulla Daphne, Tocci Noah X, Ellis Ryan C, Bennett William C, Carvhalo Alvaro, Tu Chao, Turan Alparslan, Tastaldi Luciano, Prabhu Ajita S, Krpata David M, Beffa Lucas R, Miller Benjamin T, Rosen Michael J, Petro Clayton C
Аннотация
PURPOSE: Evaluate the impact of sugammadex on gastrointestinal recovery following complex AWR.
METHODS: This single-center, double-blinded, randomized controlled trial randomized 184 patients undergoing open retromuscular AWR to receive either sugammadex or neostigmine/glycopyrrolate for neuromuscular blockade reversal per drug packaging protocol. The primary outcome was time to gastrointestinal recovery (GI-2), defined as tolerance of solid food and first bowel movement and univariate and multivariate analysis was used to compare sugammadex and neostigmine/glycopyrrolate cohorts. Secondary outcomes included incidence of POI, hospital length of stay, and opioid consumption among our two cohorts.
RESULTS: The final analysis included 177 patients (88 sugammadex, 89 neostigmine/glycopyrrolate). Median time to GI-2 recovery was similar between groups (89 vs. 87 h, Wilcoxon rank-sum p = 0.637). No significant differences were observed in POI incidence (21% vs. 25%, p = 0.52) or length of stay (5 vs. 4 days, p = 0.90). Multivariable analysis confirmed sugammadex did not significantly affect time to GI-2 recovery (HR 0.96, 95% CI 0.69-1.32, p = 0.79). Independent predictors of delayed recovery included POI development and greater opioid consumption.
CONCLUSIONS: Sugammadex did not result in faster return to gastrointestinal function when compared with neostigmine/glycopyrrolate when used for neuromuscular blockade reversal. Thus, avoidance of neostigmine/glycopyrrolate did not reduce POI incidence or hospital length of stay in patients undergoing complex AWR.
METHODS: This single-center, double-blinded, randomized controlled trial randomized 184 patients undergoing open retromuscular AWR to receive either sugammadex or neostigmine/glycopyrrolate for neuromuscular blockade reversal per drug packaging protocol. The primary outcome was time to gastrointestinal recovery (GI-2), defined as tolerance of solid food and first bowel movement and univariate and multivariate analysis was used to compare sugammadex and neostigmine/glycopyrrolate cohorts. Secondary outcomes included incidence of POI, hospital length of stay, and opioid consumption among our two cohorts.
RESULTS: The final analysis included 177 patients (88 sugammadex, 89 neostigmine/glycopyrrolate). Median time to GI-2 recovery was similar between groups (89 vs. 87 h, Wilcoxon rank-sum p = 0.637). No significant differences were observed in POI incidence (21% vs. 25%, p = 0.52) or length of stay (5 vs. 4 days, p = 0.90). Multivariable analysis confirmed sugammadex did not significantly affect time to GI-2 recovery (HR 0.96, 95% CI 0.69-1.32, p = 0.79). Independent predictors of delayed recovery included POI development and greater opioid consumption.
CONCLUSIONS: Sugammadex did not result in faster return to gastrointestinal function when compared with neostigmine/glycopyrrolate when used for neuromuscular blockade reversal. Thus, avoidance of neostigmine/glycopyrrolate did not reduce POI incidence or hospital length of stay in patients undergoing complex AWR.