ReviewCureus2026
The Effect of Sugammadex Versus Neostigmine on Postoperative Cognitive Recovery: A Systematic Review and Meta-Analysis.
Review in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
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Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Postoperative cognitive dysfunction is a major clinical concern, particularly in elderly patients, leading to reduced quality of life and increased mortality. The impact of neuromuscular blockade reversal agents, such as sugammadex and neostigmine, on cognitive recovery remains uncertain. A systematic search of PubMed, EMBASE, and Cochrane databases identified randomized controlled trials (RCTs) and observational studies comparing sugammadex and neostigmine (± anticholinergics) for reversal of neuromuscular blockade in adults under general anesthesia for elective surgery. Studies published up to February 2025 that used the Mini-Mental State Examination (MMSE) or the cognitive domain of the Postoperative Quality Recovery Scale (PQRS) were included, as they both evaluate cognition on multiple aspects. Standardized mean differences (SMD) and standard errors (SE) were calculated, and a meta-analysis using the generic inverse variance method was performed. Heterogeneity was assessed with the I² statistic. Six RCTs and three observational studies, including 1,116 patients, were analyzed. Sugammadex was associated with better early cognitive recovery (40 to 60 minutes postoperatively) compared to neostigmine (SMD 0.20; 95% CI (0.07, 0.33); p = 0.003). No significant cognitive differences were observed immediately (≤15 minutes), on day one, or on days three to seven postoperatively. Sugammadex also improved physiological recovery at 40 minutes (RR 1.20; 95% CI (1.09, 1.30); p < 0.0001). Sensitivity analysis confirmed these findings. No differences were found in nociceptive, emotive, activities of daily living, or overall recovery domains. Sugammadex may improve early postoperative cognitive and physiological recovery over neostigmine, which could lead to a faster post-anesthesia care unit (PACU) discharge. No differences were observed at other time points or PQRS domains.
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