Liu Bo, Song Keqin, Wang Peilin, Li Fangshuo, Guo Qianfeng
Department of Anesthesiology, Zhoushan Hospital, Zhoushan, Zhejiang, 316002, China.
Department of Anesthesiology, 905 Hospital of People's Liberation Army Navy, Shanghai, 200050, China.
Perioper Med (Lond). 2025 Jul 10;14(1):72. doi: 10.1186/s13741-025-00557-1.
The incidence of respiratory dysfunction associated with postoperative residual curarization (PORC) after thoracic surgery is high, even affecting the prognosis. There is no consensus on whether sugammadex is beneficial. This study aimed to elucidate the effect of sugammadex in the management of PORC-related respiratory dysfunction following thoracic surgery.
PubMed, Embase, Cochrane Library, and Web of Science were searched from database inception to January 2025 for studies on respiratory outcomes after thoracic surgery when sugammadex was used as an antagonist. The pooled risk ratio or weighted mean difference was used to evaluate the outcomes.
Among 1398 studies searched, 11 studies were finally included, involving 1445 subjects. The results showed that sugammadex could reduce the incidence of postoperative respiratory complications (RR = 0.77, 95% CI: 0.66-0.90), particularly atelectasis (RR = 0.61, 95% CI: 0.47-0.79) and pneumonia (RR = 0.64, 95% CI: 0.46-0.91). In addition, according to the subgroup analysis by age, surgery type, anesthesia duration, and body mass index, sugammadex was associated with a shortened extubation period (P ≤ 0.005).
Compared with traditional muscle relaxant antagonists, the use of sugammadex after thoracic surgery can help reverse the respiratory dysfunction related to residual muscle relaxants and reduce the risk of atelectasis, pneumonia, and reintubation. However, there is no difference in the risk of pleural effusion and pneumothorax. Except for post-anesthesia care unit duration, the differences in hospitalization and chest tube dwelling duration between the two groups remain to be clarified.
胸外科手术后与术后残余肌松（PORC）相关的呼吸功能障碍发生率较高，甚至影响预后。关于舒更葡糖是否有益尚无共识。本研究旨在阐明舒更葡糖在处理胸外科手术后PORC相关呼吸功能障碍中的作用。
从数据库建立至2025年1月，检索PubMed、Embase、Cochrane图书馆和Web of Science，以查找使用舒更葡糖作为拮抗剂时胸外科手术后呼吸结局的研究。采用合并风险比或加权平均差来评估结局。
在检索的1398项研究中，最终纳入11项研究，涉及1445名受试者。结果显示，舒更葡糖可降低术后呼吸并发症的发生率（RR = 0.77，95%CI：0.66 - 0.90），尤其是肺不张（RR = 0.61，95%CI：0.47 - 0.79）和肺炎（RR = 0.64，95%CI：0.46 - 0.91）。此外，根据年龄、手术类型、麻醉持续时间和体重指数进行的亚组分析，舒更葡糖与拔管时间缩短相关（P≤0.005）。
与传统肌松拮抗剂相比，胸外科手术后使用舒更葡糖有助于逆转与残余肌松剂相关的呼吸功能障碍，并降低肺不张、肺炎和再次插管的风险。然而，在胸腔积液和气胸风险方面没有差异。除麻醉后监护病房时长外，两组在住院时间和胸管留置时间方面的差异仍有待阐明。
