Sugammadex is associated with shorter hospital length of stay after open lobectomy for lung cancer: a retrospective observational study

Abstract

Background Sugammadex is associated with few postoperative complications. Postoperative pulmonary complications (PPC) are related to prolonged hospitalizations. Present study explored whether the use of sugammadex could reduce PPCs and thereby reduce hospital length of stay (LOS) after lung surgery. Methods We reviewed the medical records of patients who underwent elective open lobectomy for lung cancer from January 2010 to December 2015. Patients were divided into the sugammadex group and pyridostigmine group. The primary outcome was hospital LOS and secondary outcomes were postoperative complications and overall survival at 1 year. The cohort was subdivided into patients with and without prolonged LOS to explore the effects of sugammadex on outcomes in each group. Risk factors for LOS were determined via multivariate analyses. After propensity score matching, 127 patients were assigned to each group. Results Median hospital LOS was shorter (10.0 vs. 12.0 days) and the incidence of postoperative atelectasis was lower (18.1 vs. 29.9%) in the sugammadex group. However, no significant difference in overall survival between the groups was seen over 1 year (hazard ratio, 0.967; 95% confidence interval, 0.363 to 2.577). Sugammadex was a predictor related to LOS (exponential coefficient 0.88; 95% CI 0.82–0.95). Conclusions Our data suggest that sugammadex is a preferable agent for neuromuscular blockade (NMB) reversal than cholinesterase inhibitors in this patient population. Trial registration This study registered in the Clinical Research Information Service of the Korea National Institute of Health (approval number: KCT0004735, Date of registration: 21 January 2020, Retrospectively registered).

Analgesic and Anesthetic Efficacy of Rocuronium/Sugammadex in Otorhinolaryngologic Surgery: A Propensity Score-Matched Analysis

“…In addition, our study did not show a significant difference in the length of hospital stay between the two groups. In contrast, previous studies revealed that the administration of sugammadex reduced the length of hospital stay in major abdominal and thoracic surgeries [ 48 , 49 ]. We speculate that this may be because patients undergoing major surgery are at moderate to high risk of postoperative pulmonary complications [ 50 , 51 ], and sugammadex may reduce these risks [ 9 ].…”

Analysis of the association of sugammadex with the length of hospital stay in patients undergoing abdominal surgery: a retrospective study

“…Postoperative pulmonary complication rate and average time from operation to discharge were reported to be significantly reduced in patients administered sugammadex than those administered pyridistigmine [ 43 , 44 ]. Ren M et al compared the cost-effectiveness of using sugammadex versus neostigmine in laparoscopic surgery and reported that sugammadex decreased the incidence of postoperative respiratory complications and related costs [ 45 ].…”

Choice of neuromuscular block reversal agent to reduce postoperative pulmonary complications

“…Intrathoracic surgery is associated with increased incidence of atelectasis and other PPCs because of the need for one-lung ventilation during surgery [ 5 ]. In a retrospective observational study of patients undergoing open lung lobectomy, the primary outcomes of hospitalization duration and postoperative atelectasis were significantly lower with sugammadex than with pyridostigmine [ 70 ]. Similarly, in a retrospective study of patients undergoing single-port video-assisted lung lobectomy, early postoperative abnormalities on chest radiography were significantly lesser with sugammadex than with pyridostigmine [ 71 ].…”