Evidence map›Paper›PMID 40186115›Full record

SynthesisBMC anesthesiology2025

The effect of neuromuscular blocking reversal agents on perioperative neurocognitive function after general anaesthesia: a systematic review and meta-analysis.

Hao Wang, Xinghua Lv, Lin Wu, Fangli Ma, Ling Wang, Yongqi Wang, Xiaoxia Wang, Yulan Li

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in BMC anesthesiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Comprehensive Review of Anesthetic Strategies for Patients With Neurodegenerative Diseases.Medical science monitor : international medical journal of experimental and clinical research · 2026
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Hao WangAmbulatory Surgery Center, The First Hospital of Lanzhou University, Lanzhou, Gansu, China.
Xinghua LvAmbulatory Surgery Center, The First Hospital of Lanzhou University, Lanzhou, Gansu, China.
Lin WuAmbulatory Surgery Center, The First Hospital of Lanzhou University, Lanzhou, Gansu, China.
Fangli MaAmbulatory Surgery Center, The First Hospital of Lanzhou University, Lanzhou, Gansu, China.
Ling WangAmbulatory Surgery Center, The First Hospital of Lanzhou University, Lanzhou, Gansu, China.
Yongqi WangDepartment of Anesthesiology, The First Hospital of Lanzhou University, Lanzhou, Gansu, China.
Xiaoxia WangAmbulatory Surgery Center, The First Hospital of Lanzhou University, Lanzhou, Gansu, China.
Yulan LiDepartment of Anesthesiology, The First Hospital of Lanzhou University, Lanzhou, Gansu, China. ldyyrjsszx1214@163.com.

Funding

Natural Science Joint Fund of Gansu Province 24JRRA914
6 · The paper itself

Abstract

backgroundPerioperative neurocognitive dysfunction (PND) is influenced by various perioperative factors. Recent studies suggest that neuromuscular blocking reversal agents (NMBRs) may impact on PND. However, the results have been inconsistent. Therefore, we aimed to compare the effects of perioperative NMBRs on PND through this systematic review and meta-analysis.

methodsWe searched PubMed, CENTRAL, Embase, Web of Science, Scopus, and China Biology Medicine from their inception until May 2024. Two reviewers independently identified randomized controlled trials (RCTs) that compared the perioperative use of NMBRs with either a placebo or other NMBRs in patients undergoing general anaesthesia. We assessed the certainty of the evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. The primary outcome was the incidence of PND within 7 days following surgery, while the secondary outcomes included the time required to achieve a Train-of-Four ratio (TOF) ≥ 0.9 after administration of NMBRs, length of stay (LOS) in both the post-anaesthesia care unit (PACU) and the hospital, as well as the risk of adverse events (i.e. postoperative nausea and vomiting (PONV) and mortality).

resultsA total of 10 randomized controlled trials involving 1705 patients compared the effects of NMBRs on PND. Neostigmine and sugammadex are the most commonly used NMBRs in clinical anaesthesia practice. In the primary analyses of all regimens, sugammadex significantly reduced the incidence of PND compared to neostigmine (risk ratio [RR] 0.67; 95% confidence interval [CI]:0.48-0.94; I

conclusionsThis meta-analysis demonstrated that the use of sugammadex was associated with improved early perioperative neurocognitive function compared to neostigmine when used to reverse neuromuscular blockade, without an increase in the incidence of adverse events. SYSTEMATIC REVIEW PROTOCOL: PROSPERO CRD42024520287.

Indexed as

Anesthesia, GeneralNeurocognitive DisordersNeuromuscular Blocking AgentsHumansNeostigmineNeuromuscular BlockadeRandomized Controlled Trials as TopicSugammadexNeostigmineNeuromuscular Blocking AgentsSugammadexMeta-analysisNeostigmineNeuromuscular blocking reversed agentsPostoperative neurocognitive disordersSugammadexSystematic review

Identifiers

PMID40186115
PMCPMC11969733

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.