Table 1 The general characteristics of the enrolled studies
Study (Reference) | Year | Region | Type of surgery | Patient age range & ASA status | Patients enrolled (Gender: F/M, n) | Dosage of NMBA | Intervention (n) | Comparison (n) | Time of reversal agents administration | Outcomes |
|---|---|---|---|---|---|---|---|---|---|---|
Plaud B [21] | 2009 | Multicenter (France, UK, Finland and Germany) | Surgery in supine position | 28 d-17 y (ASA I-II) | 31/32, 62 | Rocuronium 0.6 mg/kg | Sugammadex (0.5, 1.0, 2.0, or 4.0 mg/kg) (n = 47) | Placebo (n = 11) | Reappearance of T2 | I, III |
Veiga RG [22] | 2011 | Spain | Elective surgery | 2–9 y (Not mentioned) | 24 | Rocuronium 0.45 mg/kg | Sugammadex 2.0 mg/kg (n = 14) | Neostigmine 5 mcg/kg + atropine 2.5 mcg/kg(n = 10) | Reappearance of T2 three timess | I |
Alvarez- Gomez JA [23] | 2012 | Multicenter | Not mentioned | 2–11 y (Not mentioned) | 96 | Rocuronium 0.6 mg/kg | Sugammadex 4.0 mg/kg (n = 49) | Neostigmine 50 mcg/kg + atropine 25 mcg/kg (n = 47) | Post-titanic count > 2 | I-III |
Gaona D [24] | 2012 | Multicenter | Short length surgery | 2–11 y (Not mentioned) | 30 | Rocuronium 0.6 mg/kg | Sugammadex 4.0 mg/kg (n = 15) | Neostigmine 50 mcg/kg + atropine 25 mcg/kg (n = 15) | Post-titanic count < 2–3 in Sugammadex group; Post-titanic count > 2–3 in Control group | I-III |
Kara T [25] | 2014 | Turkey | Elective lower abdominal/urogenital procedures | 2–12 y (ASA I) | 80 | Rocuronium 0.6 mg/kg | Sugammadex 2.0 mg/kg (n = 40) | Neostigmine 30 mcg/kg + atropine 10 mcg/kg (n = 40) | Reappearance of T2 | I-III |
Ozgün C [26] | 2014 | Turkey | Ear nose and throat surgery | 2–12 y (ASA I) | 29/31, 60 | Rocuronium 0.6 mg/kg | Sugammadex 2.0 mg/kg (n = 30) | Neostigmine 60 mcg/kg + atropine 20 mcg/kg (n = 30) | Reappearance of T2 | I, III |
Ghoneim AA [27] | 2015 | Egypt | Elective craniotomy for posterior fossa tumor excision | 7–18 y (ASA I-III) | 20/20,40 | Rocuronium 0.6 mg/kg | Sugammadex 4.0 mg/kg (n = 20) | Neostigmine 40 mcg/kg + atropine 20 mcg/kg (n = 20) | Reappearance of T2 | I, III |
El sayed M [28] | 2016 | Egypt | Outpatient tonsillectomy | 2–10 y (Not mentioned) | 37/33,70 | Rocuronium 0.6 mg/kg | Sugammadex 2.0 mg/kg (n = 35) | Neostigmine 50 mcg/kg + atropine 10 mcg/kg (n = 35) | Reappearance of T2 | I-III |
Güzelce D [29] | 2016 | Turkey | Lower urinary tract surgery and inguinal hernia | 2–17 y (ASA I) | 37 | Rocuronium 0.6 mg/kg | Sugammadex 2.0 mg/kg (n = 16) | Neostigmine 50 mcg/kg + atropine 20 mcg/kg (n = 21) | Reappearance of T2 | I-III |
Mohamad Zaini RH [30] | 2016 | Malaysia | Not mentioned | 2–18 y (ASA I-II) | 21/59,80 | Rocuronium 0.6 mg/kg | Sugammadex 2.0 mg/kg (n = 40) | Neostigmine 50 mcg/kg + atropine 20 mcg/kg (n = 40) | Reappearance of T2 | I-III |
Ammar AS [31] | 2017 | Egypt | Lower abdominal surgery | 2–10 y (ASA I-II) | 22/38, 60 | Rocuronium 0.6 mg/kg | Sugammadex 4.0 mg/kg (n = 30) | Neostigmine 0.35 mg/kg + atropine 0.02 mg/kg (n = 30) | Post-titanic count of 1–2 in Sugammadex group; Reappearance of T2 in Control group | I-III |
Korkmaz MO [32] | 2019 | Turkey | Adenotonsillectomy | 2–13 y (Not mentioned) | 30/40, 70 | Rocuronium 0.6 mg/kg | Sugammadex 2.0 mg/kg (n = 35) | Neostigmine 20 mcg/kg + atropine 10 mcg/kg (n = 35) | Reappearance of T2 | II, III |
An J [33] | 2019 | Korea | Entropion surgery | 2–11 y (ASA I-II) | 26/34, 60 | Rocuronium 0.6 mg/kg | Sugammadex 2.0 mg/kg (n = 30) | Pyridostigmine 0.2 mg/kg + glycopyrrolate 0.01 mg/kg (n = 30) | TOF ratio ≥ 0.1 | I-III |
Hussein AA [34] | 2020 | Egypt | Outpatient surgical procedures | 2–18 y (ASA I-II) | 43/37, 80 | Rocuronium 0.6 mg/kg | Sugammadex 2.0 mg/kg (n = 40) | Neostigmine 30 mcg/kg + atropine 20 mcg/kg (n = 40) | Reappearance of T2 | I-III |
Li XB [35] | 2020 | China | Elective cardiac surgery | 2–6 y (ASA II-III) | 26/34, 60 | Rocuronium 0.6 mg/kg | Sugammadex 4.0 mg/kg (n = 30) | Placebo (n = 30) | TOF ratio = 0 and PTC = 1–2 | I-III |
Li L [36] | 2020 | China | Cardiac surgery | 1–6 y (ASA II-III) | 34/26, 60 | Rocuronium 0.6 mg/kg | Sugammadex 4.0 mg/kg (n = 30) | Neostigmine 30 mcg/kg + atropine 15 mcg/kg (n = 30) | TOF ratio ≥ 0.25 | I-III |
Hu J [37] | 2020 | China | Laparoscopic inguinal hernia repair | 6 m-7 y (ASA I-II) | 8/32, 40 | Rocuronium 0.6 mg/kg | Sugammadex 2.0 mg/kg (n = 20) | Neostigmine 0.05 mg/kg + atropine 0.01 mg/kg (n = 20) | Reappearance of T2 | I-III |
Jiang Y [38]s | 2020 | China | Elective tonsillectomy | 3–6 y (ASA I-II) | 60 | Rocuronium 0.6 mg/kg | Sugammadex 2.0 mg/kg (n = 30) | Neostigmine 40 mcg/kg + atropine 20 mcg/kg (n = 30) | Reappearance of T2 | I-III |