ArticleAnaesthesiology intensive therapy2021
Identifying high dose neostigmine as a risk factor for post-operative respiratory complications: a case-control study.
Article in Anaesthesiology intensive therapy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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
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Who cites it
2 citing papers in PubMed, 2 citations in OpenAlex.
- Intraoperative Monitoring of Neuromuscular Blockade.Life (Basel, Switzerland) · 2023Review
- Announcing new members of the Advisory Editorial Board.Anaesthesiology intensive therapy · 2021Article
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
introductionNeostigmine, an acetylcholinesterase inhibitor, is used to reverse the effects of non-depolarizing neuromuscular blocking agents. Inappropriate dosing of neostigmine can lead to post-operative respiratory complications. Post-operative respiratory complications are associated with major morbidity and mortality. The purpose of this case-control study was to determine neuromuscular blockade-related risk factors associated with post-operative respiratory complications (specifically, reintubation, respiratory insufficiency, hypoxia, and/or aspiration). MATERIAL AND
methodsWe performed an Institutional Review Board-approved case-control study of all patients who underwent a general anesthetic requiring neuromuscular blockade at Tufts Medical Center between March 22, 2013 and June 1, 2019. Cases were patients who experienced post-operative complications. We identified 58 controls and 116 cases from a database of 130,178 patients during the 74-month study period.
resultsAfter adjusting for covariates, the administration of high dose neostigmine (> 60 mg per kg ideal body weight) was associated with increased odds of post-operative respiratory complications (odds ratio = 8.2; 95% CI: 2.5-26.6, P < 0.001). Rocuronium dose and the use of train-of-four peripheral nerve stimulator were not associated with post-operative respiratory complications.
conclusionsHigh dose neostigmine was identified as an independent risk factor for post-operative respiratory complications. Our study suggests that inappropriate dosing of neostigmine continues to be a problem despite growing evidence of an association with respiratory complications.
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