• Br J Anaesth · Oct 2024

    Review

    Sugammadex and neuromuscular disease: a systematic review with assessment of reporting quality and content validity.

    • Alexis Schneider, Martin R Tramèr, Gleicy Keli-Barcelos, and Nadia Elia.
    • Division of Anaesthesiology, Department of Anaesthesiology, Pharmacology, Intensive Care and Emergency Medicine, Geneva University Hospitals, Geneva, Switzerland. Electronic address: alexis.schneider@hug.ch.
    • Br J Anaesth. 2024 Oct 1; 133 (4): 752758752-758.

    BackgroundEfficacy and safety of sugammadex for the reversal of neuromuscular blocking agents (NMBAs) in patients with neuromuscular diseases remains unclear. We summarised the available evidence and evaluated the quality of data reporting and the validity of published reports.MethodsWe searched for reports (any design) on the usage of sugammadex (any regimen) for the reversal of an NMBA in patients (any age) with any neuromuscular disease. We used a modified CARE checklist (maximum score 23) to assess the quality of data reporting and an original specific validity checklist (maximum score 41) that was developed through a Delphi process.ResultsWe retrieved 126 observational reports (386 patients). Most dealt with myasthenia gravis patients receiving rocuronium. The train-of-four ratio returned to ≥0.9 in 258 of 265 (97.4%) patients in whom neuromonitoring was used. Adverse events occurred in 14 of 332 (4.2%) patients in whom adverse events were reported as present or absent. In 90 case reports, the median score of the 23-point CARE checklist was 13.5 (inter-quartile range [IQR] 11-16). In all 126 reports, the median score of the 41-point validity checklist was 23 (IQR 20-27). Scores were positively correlated.ConclusionsThese uncontrolled observations (of mainly low to moderate quality and validity) do not allow confident assessment of the efficacy and safety of sugammadex for the reversal of NMBAs in patients with neuromuscular diseases. Reporting of observational data should follow established guidelines, include specific information to ensure validity, and emphasise what the new data add to current knowledge.Systematic Review ProtocolPROSPERO 2019 (CRD42019119924).Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.

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