Author: Zhao Dan, et al.
Anesthesia & Analgesia ():10.1213/ANE.0000000000007663, July 31, 2025. doi:10.1213/ANE.0000000000007663
Summary
Zhao and colleagues comment on a randomized trial by Togioka et al. comparing sugammadex with neostigmine-glycopyrrolate for neuromuscular blockade reversal in colorectal surgery. While sugammadex led to faster reversal and earlier bowel function recovery, the letter raises concerns regarding unreported baseline gastric emptying rates, the timing of antagonist administration during closure, and the lack of extended postoperative opioid consumption data. These limitations, the authors argue, may influence interpretation of sugammadex’s true effect on gastrointestinal recovery.
Practical implications
• Clinicians should be cautious about premature reversal during open abdominal procedures to avoid wound complications.
• Future trials should control for baseline gastric emptying rates and postoperative opioid use.
• Sugammadex may still offer faster reversal and GI recovery, but timing and perioperative opioid management are key.
References
Zhao Dan, et al. Anesthesia & Analgesia ():10.1213/ANE.0000000000007663, July 31, 2025. doi:10.1213/ANE.0000000000007663