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Article summary:
1. A multicenter observational matched-cohort study was conducted to investigate the association between neuromuscular blockade reversal (neostigmine vs. sugammadex) and major pulmonary complications in adult patients undergoing elective inpatient noncardiac surgical procedures with general anesthesia and endotracheal intubation.
2. The results of the study showed that sugammadex administration was associated with a 30% reduced risk of pulmonary complications, 47% reduced risk of pneumonia, and 55% reduced risk of respiratory failure compared to neostigmine.
3. The use of sugammadex was associated with a clinically and statistically significant lower incidence of major pulmonary complications among a generalizable cohort of adult patients undergoing inpatient surgery at U.S. hospitals.
Article analysis:
The article is generally reliable and trustworthy as it is based on a multicenter observational matched-cohort study which included 12 U.S. Multicenter Perioperative Outcomes Group hospitals, making it applicable to a wide range of patients undergoing elective inpatient noncardiac surgical procedures with general anesthesia and endotracheal intubation receiving a nondepolarizing neuromuscular blockade agent and reversal. The authors also used exact matching criteria such as institution, sex, age, comorbidities, obesity, surgical procedure type, and neuromuscular blockade agent (rocuronium vs vecuronium) to ensure that the results were accurate and unbiased. Furthermore, other preoperative and intraoperative factors were compared and adjusted in the case of residual imbalance to further reduce any potential bias or confounding variables that may have affected the results.
The article does not appear to be one-sided or promotional as it presents both sides equally by providing an overview of both neostigmine and sugammadex for neuromuscular blockade reversal before discussing the results from the study which showed that sugammadex administration was associated with a lower incidence of major pulmonary complications compared to neostigmine administration. Additionally, possible risks are noted throughout the article such as potential bias due to residual imbalance between groups or confounding variables that may affect the results which further adds to its trustworthiness and reliability.