Although there is some statistically significant improvement in very early post-operative physiology for sugammadex vs neostigmine, it is not clinically significant, persistent nor occurs in other recovery domains.

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• Na Young Kim, Jae Chul Koh, Ki-Young Lee, Sung Soo Kim, Jung Hwa Hong, Hoon Jae Nam, and Sun-Joon Bai.
• Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea.
• J Clin Anesth. 2019 Nov 1; 57: 97-102.

Study ObjectiveTo evaluate the influence of reversal of neuromuscular blockade with sugammadex or neostigmine on postoperative quality of recovery following a single bolus dose of rocuronium after pars plana vitrectomy (PPV) under general anesthesia.DesignProspective, double-blind, randomized controlled trial.SettingThis study was conducted in a University Teaching Hospital from February to July 2017.PatientsA total of 84 patients with an American Society of Anesthesiologists physical status of I or II who were scheduled to undergo PPV under general anesthesia.InterventionsThe patients were randomly assigned to the neostigmine (Group N, n = 44) or sugammadex (Group S, n = 40) groups; 3 ml of study drug was prepared for the patients. For patients in Group N, a solution of neostigmine methylsulfate (1 mg) and glycopyrrolate (0.2 mg) was prepared, while a solution of sugammadex sodium (2 mg/kg) and normal saline was prepared for patients in Group S.MeasurementsThe primary endpoint was the effect of sugammadex, compared with neostigmine, on the recovery rate in the physiological domain in patients who underwent PPV with general anesthesia. The quality of recovery was assessed using the Postoperative Quality Recovery Scale at 15 min and 40 min after surgery, and on postoperative day 1.Main ResultsThe recovery rate in the physiological domain was higher in Group S at 15 min after surgery (P = 0.020). Though there were no significant differences in the overall cognitive recovery domain, patients in Group S could recall more numbers in reverse order. However, there were no significant differences between the groups in the other domains of the scale.ConclusionsThe use of sugammadex may increase the quality of physiological recovery at early postoperative periods, compared with that of neostigmine, following a single bolus dose of rocuronium in patients undergoing PPV with general anesthesia.Trial RegistrationRegistered at ClinicalTrials.gov (https://clinicaltrials.gov/ct2/show/NCT03108989). Registration number: NCT03108989.Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.

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