• Hye-Yeon Cho, Hyerin Kim, Susie Yoon, Ho-Jin Lee, Hongbeom Kim, Hyung-Chul Lee, Won-Ho Kim, and Jin-Young Jang.
• Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, South Korea.
• Minerva Anestesiol. 2021 Oct 1; 87 (10): 1100-1108.

BackgroundThis study aimed to investigate the association between sugammadex use and the occurrence of delayed passage of first flatus and oral intake tolerance following open pancreaticoduodenectomy (PD).MethodsWe reviewed consecutive patients who underwent open PD between 2015 and 2019; subsequently, they were divided into the sugammadex (group S) and neostigmine with anticholinergics (group N) groups based on the reversal agent used. We performed stabilized inverse probability of treatment weighting (IPTW) analysis to adjust for baseline differences between the groups. We compared the delayed passage of first flatus, oral intake tolerance, and other postoperative outcomes between the groups before and after IPTW.ResultsOf the 736 included patients, 309 (42.0%) received sugammadex. Stabilized IPTW revealed a significantly lower occurrence of delayed passage of first flatus in group S (19.3%) compared to group N (28.3%) (OR 0.61, 95% CI: 0.43-0.86, P=0.005). Further, there was a significantly lower occurrence of delayed oral intake tolerance in group S (19.9%) than in group N (27.7%) (OR 0.65, 95% CI: 0.46-0.92, P=0.016).ConclusionsCompared to previous reversal agents, sugammadex use was significantly associated with a decrease in the occurrence of prolonged time to first flatus and oral intake tolerance following open PD.

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