AUTHOR=Lu Xiaofei , Li Tingting , Chen Xu , Xu Meiying , Wu Jingxiang , Qiu Yuwei 

TITLE=Sugammadex shortens the time to extubate and discharge from PACU in patients with tracheobronchial stenosis undergoing rigid bronchoscopy procedures: A retrospective cohort study

JOURNAL=Frontiers in Anesthesiology

VOLUME=Volume 1 - 2022

YEAR=2023

URL=https://www.frontiersin.org/journals/anesthesiology/articles/10.3389/fanes.2022.1116271

DOI=10.3389/fanes.2022.1116271

ISSN=2813-480X

ABSTRACT=Introduction
Incomplete reversal of neuromuscular blocking drugs can delay patients’ rapid recovery and lead to adverse events in the postoperative period, especially in high-risk patients. Sugammadex as a reversal agent, may offer distinct advantages to the scenario where residual neuromuscular blockade may be poorly tolerated. We aimed to investigate the efficacy of sugammadex compared with neostigmine on perioperative outcomes in patients with preoperative tracheal stenosis undergoing rigid bronchoscopy.
Method 
We conducted a retrospective cohort study of adults who were diagnosed with primary or secondary tracheobronchial stenosis, and scheduled for interventional therapy under rigid bronchoscopy, at Shanghai Chest Hospital between December 2016 and July 2020. The exposure was categorized into two groups according to the antagonists of muscle relaxants administered after surgery: Group neostigmine versus Group sugammadex. The primary outcome was the time to extubate after surgery, and the second outcome was the time to discharge from PACU. Perioperative adverse events were recorded. 
Results
A total of 98 patients undergoing rigid bronchoscopy surgery were included. Patients in Group sugammadex showed less time to extubate (16[12,22] min vs 11[8,17] min, P=0.003) and discharge from PACU ( 27［20,33］min vs 32.5［24,44］)min, P=0.013) than in Group neostigmine. The incidence and duration of intraoperative hypotension in Group sugammadex were significantly lower than that in Group neostigmine (18.5% vs 40.8%, P=0.038, 0[0,8] min vs 0[0,0] min,P=0.036 respectively). 
Conclusions
Sugammadex shortens the time to extubate and discharge from PACU in patients with tracheobronchial stenosis, accelerating postoperative recovery.