Evidence map›Paper›PMID 29020936›Full record

Trial reportBMC anesthesiology2017

Staggering the dose of sugammadex lowers risks for severe emergence cough: a randomized control trial.

Loh P S, M M Miskan, Chin Y Z, R A Zaki

Registry-linked trialOpen access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC anesthesiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07666984 (Comparison of the Effects of Neostigmine and Sugammadex on the Optic Nerve Sheath Diameter During the Postoperative Extubation Period), which is not on this map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.2field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT07666984 phase4recruitingnot on this mapstarted 2026, after this paper: background citation

Comparison of the Effects of Neostigmine and Sugammadex on the Optic Nerve Sheath Diameter During the Postoperative Extubation Period

TypeinterventionalSponsorCukurova UniversityRan2026 to 2026Enrolled86ConditionsNeuromuscular Blockade Reversal AgentArmsSugammadex 2 mg/kg, Neostigmine + Atropine
3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 12 citations in OpenAlex.

  1. Trial
  2. Trial
  3. Article
  4. Article
  5. Sugammadex in pediatric patients.Anesthesia and pain medicine · 2022
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 1 country.

Loh P SDepartment of Anesthesiology and Intensive Care, University Malaya, Lembah Pantai, 50603, Kuala Lumpur, Malaysia. lohps@ummc.edu.my.
M M MiskanKuching Hospital, Sarawak, Malaysia.
Chin Y ZDepartment of Anesthesiology and Intensive Care, University Malaya, Lembah Pantai, 50603, Kuala Lumpur, Malaysia.
R A ZakiJulius Centre University of Malaya, Department of Social & Preventive Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia.
University of Malaya · MYSarawak General Hospital · MYUniversity Malaya Medical Centre · MY

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCough on emergence has been reported as a common adverse reaction with sugammadex reversal. We investigated if staggering the dose of sugammadex will reduce emergence cough in a single-center, randomized, double-blinded study.

methodsA hundred and twenty ASA 1-3 adults were randomly reversed with 1 mg/kg sugammadex prior to extubation followed by another 1 mg/kg immediately after extubation (staggered group), single dose of 2 mg/kg sugammadex (single bolus group) or neostigmine 0.02 mg/kg with glycopyrrolate (neostigmine group).

resultsWe found 70% of patients (n = 28) reversed with single boluses of sugammadex had Grade 3 emergence cough compared to 12.5% (n = 5) in the staggered sugammadex group and 17.5% (n = 7) in the neostigmine group (p < 0.001). Besides cough, emergence agitation also appeared highest in the single bolus sugammadex group (n = 14, 35%, p = 0.005). On the other hand, staggering sugammadex lowered risks of developing severe cough (RR 0.2, p < 0.001) and agitation (RR 0.43, p = 0.010) on emergence in addition to cough (RR 0.25, p = 0.039) and early sore throat (RR 0.70, p = 0.036) in the post-anesthetic care unit. The risks for severe emergence cough (RR 0.86, p = 0.762), severe cough in the post-anesthetic care unit (RR 1.0, p = 1.000) and sore throat (RR 1.17, p = 0.502) were also not different between the staggered sugammadex group and control given neostigmine. In terms of timing, there was no delay in time taken from discontinuing anesthetic agents to reversal and extubation if sugammadex was staggered (emergence time 6.0 ± 3.2 s, p = 0.625 and reversal time 6.5 ± 3.5, p = 0.809).

conclusionsStaggering the dose of sugammadex for reversal will effectively decrease common emergence and early postoperative complications.

trial registrationANZCTR Number ACTRN12616000116426 . Retrospectively registered on 2nd February 2016.

Indexed as

Severity of Illness IndexAdultCoughDose-Response Relationship, DrugDouble-Blind MethodFemalegamma-CyclodextrinsHumansMaleMiddle AgedNeuromuscular BlockadePostoperative ComplicationsSugammadexgamma-CyclodextrinsSugammadexEmergence agitationEmergence coughReversalSore throatSugammadex

Identifiers

PMID29020936
PMCPMC5637258
OpenAlexW2761186433

What OpenQuestion holds

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LicenceCC BY
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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.