Trial reportBMC anesthesiology2025
Reversal of neuromuscular blockade after coronary artery bypass grafting: a randomized control trial.
Trial report in BMC anesthesiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03939923 (Role of Sugammadex as Reversal Agent in Patients Extubated Immediately After Isolated Coronary Artery Bypass Grafting Surgery), which is not on this map. Not yet cited in PubMed.
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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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Role of Sugammadex as Reversal Agent in Patients Extubated Immediately After Isolated Coronary Artery Bypass Grafting Surgery
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEarly extubation in cardiac surgery improves recovery and outcomes. Extubation of the airway after cardiac surgery in the operating room or in the immediate postoperative period is a key component of the optimization of outcomes in cardiac surgical patients. Specific objectives of this study included measuring time to extubation with secondary outcomes of post-extubation vital signs, lung function, and esophageal motility. Exploratory parameters included ICU stay and re-intubation in 24 h.
methodsIn this study, we compare two groups of patients undergoing coronary bypass grafting surgery (CABG) under general anesthesia with muscle relaxation. Reversal of neuromuscular blockade randomized to group 1: neostigmine and group 2: sugammadex. A standard anesthetic protocol was followed throughout the perioperative period in each of these patients with the goal of in-operating room extubation. A two-sample t-test and/or linear model was used in the data analysis.
results4 subjects were not extubated in the neostigmine group versus 1 subject in the sugammadex group. The average time to extubation in the neostigmine group was 10.4 min, (STDEV: 5.9 min) and sugammadex was 6 min, (STDEV: 4.7 min). p = 0.001 (ANOVA). Significant secondary outcome measures included patients who received sugammadex had higher heart rates at the second measurement (85.0) vs. neostigmine (79.5) p = 0.047 and higher systolic blood pressures at the second measurement point for sugammadex (111.7) vs. neostigmine (103.9) p = 0.023. 11/36 (30%) failed the Functional Dysphasia Screen in the neostigmine group versus 5/35 (14%) in the sugammadex. Subjects in the neostigmine group had an average ICU stay of 40.1 +/- 32.4 h versus 35.6 +/- 15.8 in the sugammadex group. 2 patients in the neostigmine group were re-intubated and 1 patient was placed on non-invasive positive pressure ventilation vs. no airway interventions in the sugammadex group.
conclusionsBased on the results of this study, utilizing sugammadex for reversal of neuromuscular blockade after CABG may increase early extubation in the operating room, decrease the re-intubation rates, provide a very consistent level of muscle strength for lung function, and may improve postoperative esophageal dysmotility.
trial registrationClinicalTrials.gov NCT03939923, Registration date of Feb 2, 2019.
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