Castro 2014.

Methods	Study design: prospective, controlled, randomized study Sample size calculation: no information available
Participants	Number of randomized participants: 88 Inclusion criteria: morbidly obese (MO) and scheduled for laparoscopic bariatric surgery under general anaesthesia Exclusion criteria: lack of consent, followed in chronic pain consultation, already enrolled in another study conducted at our institution (pregabalin effect as preemptive analgesia for surgery in the obese), and previous LBS in the same patient
Interventions	Anaesthesia: propofol 1.5 to 2.0 mg/kg CBW, analgesia maintained with remifentanil 0.15 to 0.30 mg/kg CBW, anaesthesia maintained with mixture of oxygen, air, and desflurane in vol % NMBA: no information available Comparison: sugammadex 2 mg/kg (n = 44) vs neostigmine 0.05 µg/kg + atropine 20 µg/kg (n = 44) Administration time of sugammadex or neostigmine: reappearance of T2
Outcomes	Pain using the visual analogue scale at 4 different moments: arrival to PACU, 30 minutes after arrival, 60 minutes after arrival, and immediately before leaving PACU; presence of postoperative nausea and vomits (PONV); and duration of PACU stay before discharge to the ward
Notes	Publication type: peer‐reviewed article Country: Portugal Conversions: none Handling of adverse events: No discrepancy exists between AEs presented in the original article and those reported in this review Authors’ conclusions: Sugammadex is associated with less pain in the PACU. This “opioid‐sparing” effect, combined with less PONV and faster discharge from the PACU, makes sugammadex an indispensable drug for this type of patient and allows fast‐track surgery in the MO Contact: first trial author Diogo S. Castro contacted by email: diogosousacastro@hotmail.com on 15.05.2016; no reply received
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Randomization was performed by the investigator using previously prepared envelopes
Allocation concealment (selection bias)	Unclear risk	Randomization was performed by the investigator using previously prepared envelopes
Blinding of participants (performance bias)	Unclear risk	Unable to assess owing to insufficient information
Blinding of personnel (performance bias)	Unclear risk	Unable to assess owing to insufficient information
Blinding of primary outcome assessment (detection bias)	Unclear risk	Unable to assess owing to insufficient information
Blinding of safety assessment (detection bias)	Unclear risk	Unable to assess owing to insufficient information
Incomplete outcome data (attrition bias) All outcomes	Low risk	No missing outcome data: 88 eligible participants were randomized into 2 groups of 44; no patients were excluded
Selective reporting (reporting bias)	Low risk	Study protocol not available, but published article clearly includes all expected outcomes
Funding bias	Unclear risk	Unable to assess owing to insufficient information
Other bias	Unclear risk	No apparent other type of bias, except no information on sample size calculation. No differences in participant characteristics between groups