ArticleBMJ (Clinical research ed.)2012
Intermediate acting non-depolarizing neuromuscular blocking agents and risk of postoperative respiratory complications: prospective propensity score matched cohort study.
Article in BMJ (Clinical research ed.), 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 84 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effects of Postoperative Residual Paralysis on Costs of Hospital Care, Length of Hospitalization and Intensive Care Unit Admission Rate
Visualization of Regional Lung Ventilation During Neostigmine or Sugammadex Enhanced Recovery From Moderate Residual Neuromuscular Blockade in the Anaesthetized Rat Using Functional Respiratory Imaging
The Effect of Intraoperative Neuromuscular Blockade on Postoperative Atelectasis in Patients Undergoing Thoracic Surgery With One Lung Ventilation: Moderate vs. Deep Block
Who cites it
84 citing papers in PubMed, 4 syntheses or guidelines pooled it, 287 citations in OpenAlex.
- Sugammadex Reduced the Incidence of Postoperative Pulmonary Complications in Susceptible Patients Identified by ARISCAT Risk Index: Systematic Review and Meta-analysis.Advances in therapy · 2023Pooled it
- Postoperative pulmonary complications after sugammadex reversal of neuromuscular blockade: a systematic review and meta-analysis with trial sequential analysis.BMC anesthesiology · 2023Pooled it
- Efficacy and safety of sugammadex for neuromuscular blockade reversal in pediatric patients: an updated meta-analysis of randomized controlled trials with trial sequential analysis.BMC pediatrics · 2022Pooled it
- Postoperative complications with neuromuscular blocking drugs and/or reversal agents in obstructive sleep apnea patients: a systematic review.BMC anesthesiology · 2018Pooled it
- Impact of neuromuscular block monitoring and reversal on postoperative pulmonary complications in thoracic surgery: a Bayesian analysis of the iPROVE-OLV trial.British journal of anaesthesia · 2025Trial
- Perioperative lung expansion and pulmonary outcomes after open abdominal surgery versus usual care in the USA (PRIME-AIR): a multicentre, randomised, controlled, phase 3 trial.The Lancet. Respiratory medicine · 2025Trial
- The effect of neostigmine on postoperative delirium after colon carcinoma surgery: a randomized, double-blind, controlled trial.BMC anesthesiology · 2022Trial
- Efficacy and safety of sugammadex doses calculated on the basis of corrected body weight and total body weight for the reversal of deep neuromuscular blockade in morbidly obese patients.The Journal of international medical research · 2021Trial
- Comparison of intubating conditions after induction with propofol and remifentanil or sufentanil : Randomized controlled REMIDENT trial for surgical tooth extraction.Der Anaesthesist · 2020Trial
- SUGAMMADEX versus neostigmine after ROCURONIUM continuous infusion in patients undergoing liver transplantation.BMC anesthesiology · 2020Trial
- Respiratory muscle activity after spontaneous, neostigmine- or sugammadex-enhanced recovery of neuromuscular blockade: a double blind prospective randomized controlled trial.BMC anesthesiology · 2019Trial
- Trial
- Deep neuromuscular blockade leads to a larger intraabdominal volume during laparoscopy.Journal of visualized experiments : JoVE · 2013Trial
- Trial
- [Influence of methylprednisolone on the reversal time of sugammadex: a randomized clinical trial].Brazilian journal of anesthesiology (Elsevier)Trial
- Monitoring of neuromuscular block for safe anesthesia: FAQs for proper understanding.Journal of anesthesia · 2026Review
- Impact of normalizing the acceleromyographic train-of-four ratio on detecting residual paralysis-a cohort study.BMC anesthesiology · 2026Article
- Postoperative pulmonary complications of desflurane- versus sevoflurane-based general anesthesia in patients with chronic obstructive pulmonary disease or asthma undergoing gastrointestinal cancer surgery: a nationwide retrospective cohort study.Journal of anesthesia · 2026Article
- Ventilation strategies and risk factors for intraoperative respiratory critical events and postoperative pulmonary complications in neonates and small infants: a secondary analysis of the NECTARINE cohortBritish journal of anaesthesia · 2025Observational
- The association between neostigmine and postoperative atelectasis in elderly patients undergoing laparoscopic pancreaticoduodenectomy: a retrospective single-center propensity score matched study.BMC anesthesiology · 2025Article
24 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
Authors and funding
10 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine whether use of intermediate acting neuromuscular blocking agents during general anesthesia increases the incidence of postoperative respiratory complications.
designProspective, propensity score matched cohort study.
settingGeneral teaching hospital in Boston, Massachusetts, United States, 2006-10.
participants18,579 surgical patients who received intermediate acting neuromuscular blocking agents during surgery were matched by propensity score to 18,579 reference patients who did not receive such agents.
main outcome measuresThe main outcome measures were oxygen desaturation after extubation (hemoglobin oxygen saturation <90% with a decrease in oxygen saturation after extubation of >3%) and reintubations requiring unplanned admission to an intensive care unit within seven days of surgery. We also evaluated effects on these outcome variables of qualitative monitoring of neuromuscular transmission (train-of-four ratio) and reversal of neuromuscular blockade with neostigmine to prevent residual postoperative neuromuscular blockade.
resultsThe use of intermediate acting neuromuscular blocking agents was associated with an increased risk of postoperative desaturation less than 90% after extubation (odds ratio 1.36, 95% confidence interval 1.23 to 1.51) and reintubation requiring unplanned admission to an intensive care unit (1.40, 1.09 to 1.80). Qualitative monitoring of neuromuscular transmission did not decrease this risk and neostigmine reversal increased the risk of postoperative desaturation less than 90% (1.32, 1.20 to 1.46) and reintubation (1.76, 1.38 to 2.26).
conclusionThe use of intermediate acting neuromuscular blocking agents during anesthesia was associated with an increased risk of clinically meaningful respiratory complications. Our data suggest that the strategies used in our trial to prevent residual postoperative neuromuscular blockade should be revisited.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.