Half-Dose Sugammadex After Neostigmine Versus Neostigmine as a Routine Reversal Agent: A Pilot Randomized Trial

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

“…Practice Guidelines table S14, http://links.lww.com/ALN/C928). A train-offour ratio greater than or equal to 0.9 was confirmed before extubation in 10 studies, 41,60,62,68,73,86,118,[173][174][175] greater than or equal to 0.8 or not stated in 5 studies, 3,12,[191][192][193] and unconfirmed in 15 studies 58,59,63,65,66,71,105,181,[183][184][185][186][187][188][189] ; in 9 studies, whether train-of-four ratio was confirmed could not be determined. 43,44,61,67,117,145,147,177,182 Neuromuscular Monitoring: Technical Performance…”

“…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 body of evidence included 41 studies (26 randomized controlled trials, 41,59–63,65–68,71,73,86,118,139,145,147,173–181 1 before–after design, 44 4 nonrandomized trials, 142,182–184 6 prospective cohort studies, 105,117,185–188 3 retrospective cohort studies, 43,189,190 and 1 fully paired study 58 ) using quantitative monitoring and sugammadex or neostigmine and reporting residual neuromuscular blockade (train-of-four ratio less than 0.9). For studies stratifying randomization, the arms were considered independent.…”

“…The body of evidence enrolling adults included 191 studies (133 randomized controlled trials, 4,59–90,92,95,98–104,110–114,118–127,132–141,145–148,155–157,163,173–181,206–254 11 nonrandomized trials, 17,128,142,182–184,191,255–258 45 cohort studies, 15,42,86,91,93,94,96,97,105–109,116,117,129–131,143,144,186–190,227,259–277 and 2 before–after designs 115,168 ) evaluating efficacy and safety of antagonist drugs for neuromuscular blockade. The randomized controlled trials enrolling only adults had a median of 88 participants (range, 16 to 350).…”