Comparison of Postoperative Gastrointestinal Motility of Sugammadex and Neostigmine in Patients Undergoing Robotic Thyroidectomy: A Retrospective Study

Postoperative bowel dysfunction poses difficulty to patients during their recovery from surgery, and reversal agents may affect bowel function. This study aimed to investigate and compare the effects of sugammadex and a neostigmine/glycopyrrolate combination on postoperative bowel movement in patients undergoing robotic thyroidectomy. The electronic medical records of 122 patients, who underwent robotic thyroidectomy between March 2018 and December 2020, were retrospectively reviewed. Demographic, clinical, and laboratory findings and the first gas-passing time after surgery were assessed. The number of patients with a first gas emission time over 24 h was significantly higher in the neostigmine group than in the sugammadex group (p = 0.008). Multivariate logistic regression analysis indicated that sugammadex was a prognostic factor for the first gas-passing time within 24 h (odds ratio = 4.60, 95% confidence interval 1.47–14.36, p = 0.005). Although postoperative bowel motility, based on the first gas emission time, was comparable, the number of patients with a first gas emission time within 24 h was significantly higher in the sugammadex group than in the neostigmine group. This shows that the use of sugammadex did not affect the delayed recovery of postoperative bowel motility after robotic thyroidectomy.

[1]  D. Schroeder,et al.  Effects of Reversal Technique for Neuromuscular Paralysis on Time to Recovery of Bowel Function after Craniotomy. , 2022, The American surgeon.

[2]  Jin‐Young Jang,et al.  Effect of sugammadex on the recovery of gastrointestional motility after open pancreaticoduodenectomy: a single-center retrospective study. , 2021, Minerva anestesiologica.

[3]  John R. Yates,et al.  Effects on Postoperative Gastrointestinal Motility After Neuromuscular Blockade Reversal With Sugammadex Versus Neostigmine/Glycopyrrolate in Colorectal Surgery Patients , 2020, The Annals of pharmacotherapy.

[4]  Hyunkyum Kim,et al.  Neuromuscular blockade reversal with sugammadex versus pyridostigmine/glycopyrrolate in laparoscopic cholecystectomy: a randomized trial of effects on postoperative gastrointestinal motility , 2019, Korean journal of anesthesiology.

[5]  D. Schroeder,et al.  Effects of Sugammadex on Time of First Postoperative Bowel Movement , 2019, Mayo Clinic proceedings. Innovations, quality & outcomes.

[6]  A. Adiamah,et al.  Neostigmine and glycopyrronium: a potential safe alternative for patients with pseudo-obstruction without access to conventional methods of decompression , 2017, BMJ Case Reports.

[7]  E. Viscusi,et al.  The Efficacy of Peripheral Opioid Antagonists in Opioid-Induced Constipation and Postoperative Ileus: A Systematic Review of the Literature , 2017, Regional Anesthesia & Pain Medicine.

[8]  B. Olesnicky,et al.  The effect of routine availability of sugammadex on postoperative respiratory complications: a historical cohort study. , 2016, Minerva anestesiologica.

[9]  A. Şen,et al.  Reversal of neuromuscular blockade with sugammadex or neostigmine/atropine: Effect on postoperative gastrointestinal motility. , 2016, Journal of clinical anesthesia.

[10]  C. Fernández-Pérez,et al.  A systematic review of sugammadex vs neostigmine for reversal of neuromuscular blockade , 2015, Anaesthesia.

[11]  R. Pino,et al.  Effects of sugammadex on incidence of postoperative residual neuromuscular blockade: a randomized, controlled study. , 2015, British journal of anaesthesia.

[12]  X. Barth,et al.  Ogilvie's syndrome-acute colonic pseudo-obstruction. , 2015, Journal of visceral surgery.

[13]  F. Godoy,et al.  Neostigmine for acute colonic pseudo-obstruction: A meta-analysis , 2014, Annals of medicine and surgery.

[14]  R. Vather,et al.  Defining Postoperative Ileus: Results of a Systematic Review and Global Survey , 2013, Journal of Gastrointestinal Surgery.

[15]  C. Ensor,et al.  Intravenous Neostigmine for Postoperative Acute Colonic Pseudo-Obstruction , 2012, The Annals of pharmacotherapy.

[16]  W. Chung,et al.  Robot-assisted endoscopic thyroidectomy for thyroid malignancies using a gasless transaxillary approach. , 2009, Journal of the American College of Surgeons.

[17]  P. White,et al.  Sugammadex Reversal of Rocuronium-Induced Neuromuscular Blockade: A Comparison with Neostigmine–Glycopyrrolate and Edrophonium–Atropine , 2007, Anesthesia and analgesia.

[18]  G. Boeckxstaens,et al.  Mechanisms of postoperative ileus , 2004, Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society.

[19]  M. Kreis,et al.  Neostigmine increases postoperative colonic motility in patients undergoing colorectal surgery. , 2001, Surgery.

[20]  J. Raeder,et al.  Neostigmine 50 μg kg−1 with glycopyrrolate increases postoperative nausea in women after laparoscopic gynaecological surgery , 2001, Acta anaesthesiologica Scandinavica.

[21]  T. Fuchs-Buder,et al.  Omitting antagonism of neuromuscular block: effect on postoperative nausea and vomiting and risk of residual paralysis. A systematic review. , 1999, British journal of anaesthesia.

[22]  M. Kimmey,et al.  Neostigmine for the treatment of acute colonic pseudo-obstruction. , 1998, The New England journal of medicine.

[23]  A. Yli-Hankala,et al.  Neostigmine with glycopyrrolate does not increase the incidence or severity of postoperative nausea and vomiting in outpatients undergoing gynaecological laparoscopy. , 1998, British journal of anaesthesia.

[24]  J. Sonner,et al.  Nausea and vomiting following thyroid and parathyroid surgery. , 1997, Journal of clinical anesthesia.

[25]  A. Boeke,et al.  Effect of antagonizing residual neuromuscular block by neostigmine and atropine on postoperative vomiting. , 1994, British journal of anaesthesia.

[26]  C. Griffiths,et al.  Acute colonic pseudo-obstruction: a pharmacological approach. , 1992, Annals of the Royal College of Surgeons of England.

[27]  F. Carli,et al.  Influence of neostigmine on postoperative vomiting. , 1988, British journal of anaesthesia.

[28]  J. Erckenbrecht,et al.  Modulation of the adrenergic system in the treatment of postoperative bowel atonia. , 1984, Scandinavian journal of gastroenterology.

[29]  J. Clark,et al.  GASTRIC EMPTYING FOLLOWING PREMEDICATION WITH GLYCOPYRROLATE OR ATROPINE , 1983 .