Table 2:
Intraoperative characteristics of patients receiving sugammadex and neostigmine in matched analytic cohort
| Neostigmine | Sugammadex | Absolute Standardized Difference | |
|---|---|---|---|
| n=22,856 | n=22,856 | ||
| Procedure duration, hours [IQR] | 3.4 [2.5, 4.7] | 3.4 [2.4, 4.7] | 0.03 |
| Estimated blood loss No. (%) | |||
| 0–500 | 21,302 (93.2) | 21,548 (94.3) | 0.05 |
| 501–1000 | 1,114 (4.9) | 951 (4.2) | |
| >1000 | 440 (1.9) | 357 (1.6) | |
| Fluid balance, mL/kg/hr [IQR] | 3.7 [1.9, 5.8] | 3.3 [1.7, 5.1] | 0.07 |
| Intraoperative opioid administered (in morphine equivalents), mg/kg/hr [IQR] | 0.3 [0.2, 0.4] | 0.3 [0.2, 0.4] | 0.17 |
| Median ventilator driving pressure (cm H2O) [IQR] | 15 [12.0, 19.0] | 15 [12.0, 19.0] | 0.08 |
| Neuromuscular blockade agent No. (%) | |||
| Vecuronium only | 5,054 (22.1) | 5,035 (22.0) | 0.01 |
| Rocuronium only | 17,553 (76.8) | 17,553 (76.8) | |
| Vecuronium and rocuronium | 249 (1.1) | 268 (1.2) | |
| Last train-of-four documented within 30 minutes of extubation No. (%) | 0.32 | ||
| Not documented | 9695 (42.4) | 6641 (29.1) | |
| 0 or 1 twitches | 377 (1.6) | 939 (4.1) | |
| 2 twitches | 503 (2.2) | 991 (4.3) | |
| 3 or 4 twitches | 12281 (53.7) | 14285 (62.5) | |
| General Anesthesia Technique | 0.11 | ||
| Volatile, with or without propofol infusion or inhaled nitrous oxide | 22,275 (97.5) | 21,869 (95.7) | |
| Propofol infusion, without inhaled volatile or nitrous oxide | 483 (2.1) | 894 (3.9) | |
| Nitrous oxide, with propofol infusion | 98 (0.4) | 93 (0.4) | |
| Primary In-Room Anesthesiology Provider | 0.06 | ||
| Faculty only | 918 (4.0) | 1,085 (4.7) | |
| Resident/fellow | 10,886 (47.6) | 10,284 (45.0) | |
| Certified registered nurse anesthetist | 11,047 (48.3) | 11,479 (50.2) | |
| Time from last NMB dose to reversal (15 minute interval) [IQR] | 4.4 [2.9, 6.7] | 4 [2.7, 6.0] | 0.14 |
| Time from reversal to Extubation (5 minute interval) [IQR] | 3 [1.8, 4.6] | 2.4 [1.4, 3.8] | 0.06 |
| Time from last NMB to extubation (15 minute interval) [IQR] | 5.6 [3.9, 8.1] | 5 [3.5, 7.3] | 0.15 |
| Intraoperative neuromuscular blockade administered (ED 95/ kg/hour) [IQR] | 1.2 [0.9, 1.6] | 1.4 [1.1,1.8] | 0.20 |
Additional variable definitions and details available in Supplemental Digital Content 2 and 3
IQR = interquartile range; NMB = neuromuscular blockade
“Intraoperative neuromuscular blockade administered” was calculated by totaling bolus and infusion administrations for vecuronium and rocuronium separately. The amount of each agent was divided by its ED 95 (0.05 mg/kg for vecuronium, 0.3 mg/kg for rocuronium) and then adjusted for weight in kg and anesthesia duration.