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Sugammadex, neostigmina y complicaciones pulmonares postoperatorias: protocolo del ensayo controlado aleatorizado
Kate Leslie1,2, Sabine Braat3,4, Jai N Darvall1,2,5
1Department of Critical Care, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia.
BJA open
|February 20, 2026
Resumen
Sugammadex puede reducir las complicaciones postoperatorias en comparación con la neostigmina. Este gran ensayo controlado aleatorizado (ECA) investigó sugammadex para la reversión del bloqueo neuromuscular en pacientes quirúrgicos, evaluando las complicaciones pulmonares y la muerte.
Área de la Ciencia:
- Anestesiología y Medicina Perioperatoria.
- Farmacología clínica Farmacología clínica.
- Medicina de cuidados críticos Medicina de cuidados críticos.
Sus antecedentes:
- Sugammadex, un nuevo agente de reversión de la ciclodextrina, es prometedor para reducir el bloqueo neuromuscular residual y las complicaciones pulmonares postoperatorias.
- Las revisiones sistemáticas anteriores de ensayos pequeños sugieren beneficios, pero se necesitan pruebas de ensayos controlados aleatorizados (ECA) a gran escala.
Objetivo del estudio:
- Para determinar si el sugammadex reduce las complicaciones pulmonares postoperatorias o la muerte en comparación con la neostigmina.
- Evaluar la eficacia y seguridad de sugammadex para la reversión del bloqueo neuromuscular en pacientes quirúrgicos adultos.
Principales métodos:
- Un ECA internacional y multicéntrico (estudio SNaPP) en el que participaron 3500 pacientes de ≥40 años sometidos a cirugía abdominal o torácica.
- Los pacientes fueron asignados al azar 1:1 para recibir sugammadex o neostigmina para la reversión del bloqueo neuromuscular.
- El resultado primario fue un compuesto de complicaciones pulmonares postoperatorias o muerte hasta el alta hospitalaria o el día postoperatorio 7.
Principales resultados:
- El análisis de los datos se realizará sobre la base de la intención de tratar.
- El estudio tiene como objetivo proporcionar evidencia definitiva sobre la efectividad comparativa de sugammadex versus neostigmina.
Conclusiones:
- Se espera que el estudio SNaPP proporcione evidencia crucial con respecto al papel de sugammadex en la mejora de los resultados de los pacientes después de la cirugía.
- Los resultados informarán las pautas de práctica clínica para la reversión del bloqueo neuromuscular.
Palabras clave:
cirugía abdominal cirugía abdominal cirugía abdominalla anestesia y la anestesia.La neostigmina también se llama neostigmina.las complicaciones pulmonares postoperatorias.ensayo controlado aleatorizado y controlado.sugammadex sugammadex sugammadex sugammadex sugammadexcirugía torácica cirugía torácica.
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