Succinylcholine and postoperative pulmonary complications: a retrospective cohort study using registry data from two hospital networks.
Adolescent
Adult
Aged
Aged, 80 and over
Dose-Response Relationship, Drug
Female
Hospitals
Humans
Lung Diseases
/ chemically induced
Male
Middle Aged
Neuromuscular Depolarizing Agents
/ adverse effects
Postoperative Complications
/ chemically induced
Registries
Retrospective Studies
Succinylcholine
/ adverse effects
Young Adult
dose–response relationship
general anaesthesia
hypoxaemia
neuromuscular blocking agent
respiratory failure
succinylcholine
Journal
British journal of anaesthesia
ISSN: 1471-6771
Titre abrégé: Br J Anaesth
Pays: England
ID NLM: 0372541
Informations de publication
Date de publication:
10 2020
10 2020
Historique:
received:
16
03
2020
revised:
18
05
2020
accepted:
19
05
2020
pubmed:
14
7
2020
medline:
10
10
2020
entrez:
14
7
2020
Statut:
ppublish
Résumé
Neuromuscular blocking agents (NMBAs) with a non-depolarising mechanism of action carry the risk of postoperative residual paralysis and are associated with postoperative pulmonary complications (POPC). Owing to the shorter duration of action, the depolarising NMBA succinylcholine may be associated with less postoperative residual paralysis, and hence fewer POPC. We tested the association of succinylcholine administration during anaesthesia and POPC. In a retrospective cohort study of registry data from two large US academic medical centres, 244 850 adult noncardiac surgical patients undergoing general anaesthesia were included. The primary outcome was POPC, defined as post-extubation haemoglobin oxygen de-saturation to <90%, or re-intubation requiring intensive care unit admission within 7 days after surgery. The association between succinylcholine and POPC and its dose-dependency were tested in a hierarchical fashion using a multivariable logistic regression model. A total of 13 206 patients (5.4%) experienced POPC. Use of succinylcholine was associated with increased risk of POPC (adjusted odds ratio [OR In contrast to our prediction, succinylcholine administration was associated with an increased risk of POPC. This association was dose-dependent and magnified in surgeries of shorter duration.
Sections du résumé
BACKGROUND
Neuromuscular blocking agents (NMBAs) with a non-depolarising mechanism of action carry the risk of postoperative residual paralysis and are associated with postoperative pulmonary complications (POPC). Owing to the shorter duration of action, the depolarising NMBA succinylcholine may be associated with less postoperative residual paralysis, and hence fewer POPC. We tested the association of succinylcholine administration during anaesthesia and POPC.
METHODS
In a retrospective cohort study of registry data from two large US academic medical centres, 244 850 adult noncardiac surgical patients undergoing general anaesthesia were included. The primary outcome was POPC, defined as post-extubation haemoglobin oxygen de-saturation to <90%, or re-intubation requiring intensive care unit admission within 7 days after surgery. The association between succinylcholine and POPC and its dose-dependency were tested in a hierarchical fashion using a multivariable logistic regression model.
RESULTS
A total of 13 206 patients (5.4%) experienced POPC. Use of succinylcholine was associated with increased risk of POPC (adjusted odds ratio [OR
CONCLUSIONS
In contrast to our prediction, succinylcholine administration was associated with an increased risk of POPC. This association was dose-dependent and magnified in surgeries of shorter duration.
Identifiants
pubmed: 32654742
pii: S0007-0912(20)30451-7
doi: 10.1016/j.bja.2020.05.059
pii:
doi:
Substances chimiques
Neuromuscular Depolarizing Agents
0
Succinylcholine
J2R869A8YF
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
629-636Commentaires et corrections
Type : CommentIn
Type : CommentIn
Type : CommentIn
Informations de copyright
Copyright © 2020 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.