title: Neostigmine for reversal of neuromuscular block in paediatric patients.
abstract: BACKGROUND
  Residual neuromuscular block is associated with serious postoperative complications. Some anaesthesiologists use neostigmine to reverse neuromuscular blockade for all paediatric surgical patients. However, the incidence of residual neuromuscular block may be lower in paediatric patients than in adults. The use of neostigmine has also caused complications, such as postoperative nausea, vomiting, excessive salivation and bradycardia. Therefore, whether neostigmine should be used routinely to reverse neuromuscular blockade in each paediatric patient is an important question for paediatric anaesthesiologists.
  
  
  OBJECTIVE
  To assess the necessity of routine usage of neostigmine in preventing residual neuromuscular blockade in paediatric patients following the use of muscle relaxants.
  
  
  METHODS
  We searched the Cochrane Central Register of Controlled Trials (CENTRAL) 2013, Issue 8, part of The Cochrane Library; MEDLINE via Ovid (1946 to August 2013); EMBASE via Ovid SP (1974 to August 2013); ClinicalTrials.gov (18 August 2013) and Chinese Clinical Trial Registry (18 August 2013) with no language restrictions.
  
  
  METHODS
  We planned to include randomized controlled trials (RCTs) comparing neostigmine versus placebo in American Society of Anaesthesiologists (ASA) I or II paediatric surgical participants (younger than 12 years of age, including newborns) who had received non-depolarizing muscle relaxants.
  
  
  METHODS
  Two review authors independently assessed the studies for inclusion.
  
  
  RESULTS
  We found no study that satisfied the inclusion criteria. We found one study awaiting classification.
  
  
  CONCLUSIONS
  No RCTs were found that supported, or argued against, the routine use of neostigmine to reverse neuromuscular block in paediatric patients.
authors.affiliation: Department of Anaesthesiology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, Sichuan, China, 610041.
authors.forename: Lei
authors.initials: L
authors.lastname: Yang
authors.forename: Di
authors.initials: D
authors.lastname: Yang
authors.forename: Qian
authors.initials: Q
authors.lastname: Li
authors.forename: Yunxia
authors.initials: Y
authors.lastname: Zuo
authors.forename: DongHao
authors.initials: D
authors.lastname: Lu
mesh_terms: D002648:Child; D006801:Humans; D009388:Neostigmine / Q000009:adverse effects / Q000627:therapeutic use*; D019148:Neuromuscular Blockade; D003473:Neuromuscular Nondepolarizing Agents / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D003473:Neuromuscular Nondepolarizing Agents; D009388:Neostigmine