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Updated: Aug 27, 2025
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Measuring the Strength of Mice
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How robust are the STRONGER and STIL-STRONGER studies?
Manfred Blobner1, Jennifer M Hunter2, Kurt Ulm3
1Department of Anaesthesiology and Intensive Care Medicine, School of Medicine, Technical University of Munich, Munich, Germany; Department of Anaesthesiology and Intensive Care Medicine, Faculty of Medicine, University of Ulm, Ulm, Germany.
British Journal of Anaesthesia
|October 1, 2022
Summary
Sugammadex reduces postoperative pulmonary complications compared to neostigmine, particularly in high-risk patients. A secondary analysis confirms sugammadex
Area of Science:
- Anesthesiology and critical care medicine.
- Pharmacology and drug safety.
- Surgical outcomes research.
Background:
- The STRONGER study (2020) first indicated sugammadex's benefit over neostigmine in reducing postoperative pulmonary complications (PPCs).
- A secondary analysis, STIL-STRONGER, re-examined data focusing on high-risk and older patients undergoing prolonged elective surgery.
- Both studies investigated the impact of neuromuscular blockade reversal agents on patient outcomes.
Discussion:
- This analysis scrutinizes the statistical methodologies employed in both STRONGER and STIL-STRONGER studies.
- It explores how potential limitations in statistical analysis might have influenced the observed differences between sugammadex and neostigmine regarding PPCs.
- The discussion emphasizes the need for careful interpretation of statistical findings in clinical research.
Key Insights:
- Sugammadex demonstrates a continued association with fewer PPCs compared to neostigmine, especially in vulnerable patient populations.
- The STIL-STRONGER study reinforces sugammadex's potential advantages in specific surgical contexts.
- Statistical nuances warrant consideration when evaluating the comparative efficacy of these reversal agents.
Outlook:
- Further research may refine statistical approaches to better elucidate the precise benefits of sugammadex.
- Clinical guidelines may evolve based on robust evidence regarding sugammadex's role in minimizing postoperative complications.
- Investigating long-term outcomes associated with different reversal agents remains an important area for future study.
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