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Comparison of the effects of sugammadex and neostigmine on hospital stay in robot-assisted laparoscopic prostatectomy: a retrospective study.
BMC Anesthesiol. 2020 07 21; 20(1):178.BA

Abstract

BACKGROUND

Sugammadex reduces postoperative complications. We sought to determine whether it could reduce the length of hospital stay, post-anesthetic recovery time, unplanned readmission, and charges for patients who underwent robot-assisted laparoscopic prostatectomy (RALP) when compared to neostigmine.

METHODS

This was a retrospective observational study of patients who underwent RALP between July 2012 and July 2017, in whom rocuronium was used as a neuromuscular blocker. The primary outcome was the length of hospital stay after surgery in patients who underwent reversal with sugammadex when compared to those who underwent reversal with neostigmine. The secondary outcomes were post-anesthetic recovery time, hospital charges, and unplanned readmission within 30 days after RALP.

RESULTS

In total, 1430 patients were enrolled. Using a generalized linear model in a propensity score-matched cohort, sugammadex use was associated with a 6% decrease in the length of hospital stay (mean: sugammadex 7.7 days vs. neostigmine 8.2 days; odds ratio [OR] 0.94, 95% confidence interval [CI] [0.89, 0.98], P = 0.008) and an 8% decrease in post-anesthetic recovery time (mean: sugammadex 36.7 min vs. neostigmine 40.2 min; OR 0.92, 95% CI [0.90, 0.94], P < 0.001) as compared to neostigmine use; however, it did not reduce the 30-day unplanned readmission rate (P = 0.288). The anesthesia charges were higher in the sugammadex group than in the neostigmine group (P < 0.001); however, there were no significant differences between the groups in terms of postoperative net charges (P = 0.061) and total charges (P = 0.100).

CONCLUSIONS

Compared to the reversal of rocuronium effects with neostigmine, reversal with sugammadex after RALP was associated with a shorter hospital stay and post-anesthetic recovery time, and was not associated with 30-day unplanned readmission rates and net charges.

Authors+Show Affiliations

Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea.Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea. Interdepartment of Critical Care Medicine, Seoul National University Bundang Hospital, 166, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Republic of Korea.Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea. songoficu@outlook.kr. Interdepartment of Critical Care Medicine, Seoul National University Bundang Hospital, 166, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Republic of Korea. songoficu@outlook.kr.Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea. Department of Anaesthesiology and Pain Medicine, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul, Republic of Korea.

Pub Type(s)

Comparative Study
Journal Article
Observational Study

Language

eng

PubMed ID

32693776

Citation

Min, Byung-Hun, et al. "Comparison of the Effects of Sugammadex and Neostigmine On Hospital Stay in Robot-assisted Laparoscopic Prostatectomy: a Retrospective Study." BMC Anesthesiology, vol. 20, no. 1, 2020, p. 178.
Min BH, Oh TK, Song IA, et al. Comparison of the effects of sugammadex and neostigmine on hospital stay in robot-assisted laparoscopic prostatectomy: a retrospective study. BMC Anesthesiol. 2020;20(1):178.
Min, B. H., Oh, T. K., Song, I. A., & Jeon, Y. T. (2020). Comparison of the effects of sugammadex and neostigmine on hospital stay in robot-assisted laparoscopic prostatectomy: a retrospective study. BMC Anesthesiology, 20(1), 178. https://doi.org/10.1186/s12871-020-01088-6
Min BH, et al. Comparison of the Effects of Sugammadex and Neostigmine On Hospital Stay in Robot-assisted Laparoscopic Prostatectomy: a Retrospective Study. BMC Anesthesiol. 2020 07 21;20(1):178. PubMed PMID: 32693776.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of the effects of sugammadex and neostigmine on hospital stay in robot-assisted laparoscopic prostatectomy: a retrospective study. AU - Min,Byung-Hun, AU - Oh,Tak Kyu, AU - Song,In-Ae, AU - Jeon,Young-Tae, Y1 - 2020/07/21/ PY - 2019/11/24/received PY - 2020/07/09/accepted PY - 2020/7/23/entrez PY - 2020/7/23/pubmed PY - 2021/9/24/medline KW - Hospital length of stay KW - Neuromuscular blocking agents KW - Reversal agents KW - Rocuronium KW - Sugammadex SP - 178 EP - 178 JF - BMC anesthesiology JO - BMC Anesthesiol VL - 20 IS - 1 N2 - BACKGROUND: Sugammadex reduces postoperative complications. We sought to determine whether it could reduce the length of hospital stay, post-anesthetic recovery time, unplanned readmission, and charges for patients who underwent robot-assisted laparoscopic prostatectomy (RALP) when compared to neostigmine. METHODS: This was a retrospective observational study of patients who underwent RALP between July 2012 and July 2017, in whom rocuronium was used as a neuromuscular blocker. The primary outcome was the length of hospital stay after surgery in patients who underwent reversal with sugammadex when compared to those who underwent reversal with neostigmine. The secondary outcomes were post-anesthetic recovery time, hospital charges, and unplanned readmission within 30 days after RALP. RESULTS: In total, 1430 patients were enrolled. Using a generalized linear model in a propensity score-matched cohort, sugammadex use was associated with a 6% decrease in the length of hospital stay (mean: sugammadex 7.7 days vs. neostigmine 8.2 days; odds ratio [OR] 0.94, 95% confidence interval [CI] [0.89, 0.98], P = 0.008) and an 8% decrease in post-anesthetic recovery time (mean: sugammadex 36.7 min vs. neostigmine 40.2 min; OR 0.92, 95% CI [0.90, 0.94], P < 0.001) as compared to neostigmine use; however, it did not reduce the 30-day unplanned readmission rate (P = 0.288). The anesthesia charges were higher in the sugammadex group than in the neostigmine group (P < 0.001); however, there were no significant differences between the groups in terms of postoperative net charges (P = 0.061) and total charges (P = 0.100). CONCLUSIONS: Compared to the reversal of rocuronium effects with neostigmine, reversal with sugammadex after RALP was associated with a shorter hospital stay and post-anesthetic recovery time, and was not associated with 30-day unplanned readmission rates and net charges. SN - 1471-2253 UR - https://www.unboundmedicine.com/medline/citation/32693776/Comparison_of_the_effects_of_sugammadex_and_neostigmine_on_hospital_stay_in_robot_assisted_laparoscopic_prostatectomy:_a_retrospective_study_ DB - PRIME DP - Unbound Medicine ER -