title: Neostigmine vs. sugammadex: observational cohort study comparing the quality of recovery using the Postoperative Quality Recovery Scale.
abstract: BACKGROUND
  Quality of postoperative recovery is an important outcome after surgery. An observational cohort study was designed to assess the quality of postoperative recovery using the Portuguese version of the Postoperative Quality Recovery Scale (PQRS) in patients treated with neostigmine vs. sugammadex as neuromuscular blocking reversal agents.
  
  
  METHODS
  A convenience sample of 101 adult patients undergoing elective surgery with general anaesthesia and treated with neostigmine (n=48) or sugammadex (n=53) as neuromuscular blocking reversal agents was included. Patients were evaluated using the Portuguese PQRS version at baseline and postoperatively at 15 (T15) and 40 (T40) min and also at days 1 and 3. Recovery was defined as return to baseline values (or better) at each time points.
  
  
  RESULTS
  The PQRS overall recovery rates were similar in both groups, but recoveries in the nociceptive (96.2% vs. 81.3%, P=0.02) and physiological (96.2% vs. 70.2%, P=0.001) domains at T40 were higher in the sugammadex group than in the neostigmine group. Also, there was a trend that patients treated with sugammadex reported significantly better global perspective on the impact of surgery on working capacity and daily activities, as well as higher satisfaction with anaesthetic care.
  
  
  CONCLUSIONS
  This pilot study suggests that sugammadex may improve physiological and nociceptive postoperative recovery as well as patient satisfaction with anaesthetic care. Although we lack an explanation for a possible favourable impact of sugammadex on quality of recovery, our results may provide sufficient preliminary data to justify a randomised trial to explore this possibility.
authors.affiliation: Department of Anesthesiology, Hospital de Santo António, Porto, Portugal.
authors.forename: P
authors.initials: P
authors.lastname: Amorim
authors.forename: F
authors.initials: F
authors.lastname: Lagarto
authors.forename: B
authors.initials: B
authors.lastname: Gomes
authors.forename: S
authors.initials: S
authors.lastname: Esteves
authors.forename: J
authors.initials: J
authors.lastname: Bismarck
authors.forename: N
authors.initials: N
authors.lastname: Rodrigues
authors.forename: M
authors.initials: M
authors.lastname: Nogueira
mesh_terms: D000328:Adult; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General / Q000379:methods; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009388:Neostigmine / Q000627:therapeutic use*; D019148:Neuromuscular Blockade / Q000379:methods; D003473:Neuromuscular Nondepolarizing Agents / Q000037:antagonists & inhibitors*; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D010865:Pilot Projects; D011183:Postoperative Complications / Q000517:prevention & control*; D000077122:Sugammadex; D047408:gamma-Cyclodextrins / Q000627:therapeutic use*
chemical_list: D002800:Cholinesterase Inhibitors; D003473:Neuromuscular Nondepolarizing Agents; D047408:gamma-Cyclodextrins; D000077122:Sugammadex; D009388:Neostigmine