Evidence map›Paper›PMID 41716251›Full record

Trial reportBJA open2026

Sugammadex, neostigmine, and postoperative pulmonary complications: protocol of the SNaPP multicentre randomised controlled trial.

Kate Leslie, Sabine Braat, Jai N Darvall, Philip J Peyton, Nancy Devlin, Paul S Myles, Tomás B Corcoran, Timothy G Short, Matthew T V Chan, Benjamin L Olesnicky and 5 more

Abstract readClinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BJA open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. 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

15 authors.

Kate LeslieDepartment of Critical Care, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia.
Sabine BraatCentre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.
Jai N DarvallDepartment of Critical Care, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia.
Philip J PeytonDepartment of Critical Care, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia.
Nancy DevlinCentre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.
Paul S MylesDepartment of Anaesthesiology and Perioperative Medicine, School of Translational Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia.
Tomás B CorcoranSchool of Medicine and Pharmacology, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia.
Timothy G ShortDepartment of Anaesthesiology, University of Auckland, Auckland, Aotearoa New Zealand.
Matthew T V ChanDepartment of Anaesthesia and Intensive Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China.
Benjamin L OlesnickySydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
An Tran-DuyCentre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.
Helen Maxwell-WrightDepartment of Critical Care, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia.
Cindy Schultz-FergusonDepartment of Critical Care, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia.
Sofia SidiropoulosDepartment of Critical Care, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia.
David A StoryDepartment of Critical Care, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Sugammadex, a novel cyclodextrin reversal agent, reduces the incidence of residual neuromuscular block compared with neostigmine and was associated with fewer postoperative pulmonary complications in a systematic review of small randomised trials. However, evidence from a large RCT is required. Methods: We designed an international, multicentre RCT (the SNaPP study). A total of 3500 patients, aged ≥40 yr and undergoing abdominal or thoracic surgery, will be enrolled and randomly allocated in a 1:1 ratio to receive sugammadex or neostigmine for reversal of neuromuscular block, stratified by centre. The primary outcome is a composite of postoperative pulmonary complications (atelectasis, pneumonia, acute respiratory distress syndrome, aspiration pneumonitis, or a combination of these) or death until hospital discharge (or postoperative day 7 if still in hospital). Secondary outcomes are components of the primary outcome, postoperative nausea and vomiting, unplanned ICU/high-dependency unit admission, days alive and at home at 30 days, and health-related quality of life at 3 months. The trial aims to determine whether sugammadex compared with neostigmine reduces the incidence of postoperative pulmonary complications or death. Data will be analysed on an intention-to-treat basis. Ethics and dissemination: The SNaPP study is approved by the ethics committees at participating sites in Australia, Aotearoa New Zealand, and Hong Kong and is endorsed by the Australian and New Zealand College of Anaesthetists Clinical Trials Network. Participant recruitment began on 20 July 2023 and was completed on 3 July 2025. Publication of the SNaPP study results is anticipated in 2026. Clinical trial registration: ACTRN 12623000394640.

Indexed as

abdominal surgeryanaesthesianeostigminepostoperative pulmonary complicationsrandomised controlled trialsugammadexthoracic surgery

Identifiers

PMID41716251
PMCPMC12914678

What OpenQuestion holds

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Registered trials

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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.