Table 3.
Study characteristics of the included studies.
| Author | Year | Country | Study design | Sample size | Study population | Cases studied | Reversal agents | Primary outcomes |
|---|---|---|---|---|---|---|---|---|
| Ajetunmobi (11) | 2025 | Canada | Double-blind randomized controlled trial | 120 | Morbidly obese adults with obstructive sleep apnea undergoing bariatric surgery | Reversal of neuromuscular blockade during bariatric surgery | Sugammadex vs. Neostigmine + Glycopyrrolate | Time from reversal administration to operating room discharge |
| Chae (16) | 2019 | South Korea | Retrospective cohort study with propensity matching | 585 (157 matched pairs) | Adults undergoing colorectal surgery | Postoperative outcomes after neuromuscular blockade reversal in colorectal surgery | Sugammadex vs. acetylcholinesterase inhibitors | Length of hospital stay, delayed discharge, and 30-day readmission |
| Han (12) | 2021 | South Korea | Prospective randomized controlled trial | 80 | Adults undergoing laparoscopic cholecystectomy | Neuromuscular blockade reversal during laparoscopic cholecystectomy | Sugammadex vs. Neostigmine | Quality of Recovery-15 score on postoperative day 1 |
| Hunt (17) | 2020 | United States | Retrospective cohort study | 224 | Adults undergoing laparoscopic colorectal surgery | Gastrointestinal recovery after neuromuscular blockade reversal | Sugammadex vs. Neostigmine + Glycopyrrolate | Time to first bowel movement after surgery |
| Ledowski (13) | 2021 | Multicenter (Australia, Hungary, Malaysia, South Korea, Netherlands) | Prospective randomized double-blind trial | 168 analysed | High-risk older patients (≥75 years) undergoing surgery with neuromuscular blockade | Postoperative pulmonary complications after neuromuscular blockade reversal | Sugammadex vs. Neostigmine | Incidence of postoperative pulmonary complications within 7 days |
| Mraovic (14) | 2021 | United States | Prospective randomized controlled trial | 40 | Geriatric patients undergoing posterior lumbar spine surgery | Recovery from rocuronium neuromuscular blockade in spine surgery | Sugammadex vs. Neostigmine + Glycopyrrolate | Time to recovery of train-of-four ratio ≥0.9 |
| Oh (18) | 2021 | South Korea | Retrospective propensity-score matched cohort study | 602 (210 matched pairs) | Patients undergoing laparoscopic colorectal cancer surgery | Post-operative respiratory outcomes associated with neuromuscular blockade reversal | Sugammadex vs. Pyridostigmine | Incidence of postoperative respiratory adverse events (SpO₂ < 94%, oxygen supplementation, rescue sugammadex use) |
| Serrano (19) | 2021 | Spain | Prospective multicenter observational cohort (secondary analysis of POWER trial) | 2084 | Adults undergoing elective colorectal surgery within enhanced recovery programs | Neuromuscular blockade monitoring and pharmacological reversal during colorectal surgery | Sugammadex vs. Neostigmine (with monitoring and reversal strategies) | Moderate–severe postoperative complications, length of hospital stay, and mortality |
| Yu (15) | 2022 | China | Double-blind randomized prospective study | 100 | Adults undergoing radical resection of lung cancer under general anesthesia | Neuromuscular block reversal and pulmonary outcomes after lung cancer surgery | Sugammadex vs. Neostigmine + Atropine | Incidence of postoperative pulmonary complications and time to achieve TOF ratio ≥0.9 |