{Reference Type}: Journal Article
{Title}: Evaluation of Neuromuscular Blockade Reversal on Postoperative Mechanical Ventilation Time in a Cardiovascular Surgery Population.
{Author}: Xia R;Kachru N;Tuazon DM;Bostan F;Fuentes A;
{Journal}: J Cardiothorac Vasc Anesth
{Volume}: 33
{Issue}: 12
{Year}: Dec 2019
{Factor}: 2.894
{DOI}: 10.1053/j.jvca.2019.06.025
{Abstract}: <B>OBJECTIVE: </B>To report on postoperative outcomes related to the administration of neostigmine for reversal of nondepolarizing neuromuscular blocking agents in cardiovascular surgery patients, with a specific focus on the duration of postoperative mechanical ventilation as the primary endpoint.<BR><B>METHODS: </B>A retrospective cohort study design was followed to achieve the study objectives.<BR><B>METHODS: </B>This was a single-center, chart review study conducted at a large academic medical center of adult patients post-cardiovascular surgery.<BR><B>METHODS: </B>Patients were included if they had received a bolus dose of perioperative nondepolarizing neuromuscular blocking agent and underwent one of the targeted cardiovascular surgeries.<BR><B>METHODS: </B>Final analysis comprised of 175 patients, 95 of whom received neostigmine and 80 who did not receive neostigmine.<BR><B>RESULTS: </B>The primary endpoint was the duration of postoperative mechanical ventilation. When controlling for all covariates, neostigmine use was associated with a 0.34-hour reduction (∼20.4 min) in duration of mechanical ventilation (parameter estimate: 0.66, 95% confidence interval 0.49-0.89; p = 0.0071). More patients who received neostigmine met the early extubation benchmark of less than 6 hours (55 v 34 patients; p = 0.04). Finally, neostigmine use was not found to be associated with increased risk of respiratory complications or postoperative nausea and/or vomiting.<BR><B>CONCLUSIONS: </B>The use of neostigmine was found to have a protective effect on the duration of postoperative mechanical ventilation without increasing the risk of adverse complications.