SynthesisMedicine2026
Comparison of the effect of neostigmine and sugammadex on postoperative delirium in surgical patients: A systematic review and meta-analysis.
Synthesis in Medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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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.
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.
Who cites it
2 citing papers in PubMed.
- Impact of Sugammadex on Clinical and Patient-Centered Outcomes: Beyond Neuromuscular Recovery.Journal of clinical medicine · 2026Review
- Comparison of the Effect of Pyridostigmine and Sugammadex on Emergence Delirium in Pediatric Patients Undergoing Strabismus Surgery: A Randomized Controlled Trial.Journal of clinical medicine · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
backgroundPostoperative delirium (POD) frequently occurs in elderly surgical patients and is associated with adverse outcomes. This review aimed to evaluate whether sugammadex, a selective neuromuscular blockade reversal agent, reduces postoperative delirium-incidence (POD-I) compared with neostigmine.
methodsPubMed, EMBASE, and Cochrane CENTRAL were searched up to May 2025 for randomized controlled trials (RCTs) and non-randomized controlled trials (NRCTs) comparing sugammadex and neostigmine regarding to POD-I. Primary outcome was POD-I, with subgroup analyses according to postoperative period (within 24 hours vs after postoperative 1 day) and the type of anticholinergic coadministered with neostigmine (atropine vs glycopyrrolate). Secondary outcome was perioperative changes in Mini-Mental State Examination scores (preoperative vs postoperative). Analyses were performed separately for RCTs and NRCTs using RevMan 5.4.
resultsTwelve studies (7 RCTs, n = 759; 5 NRCTs, n = 50,115) were included. In RCTs, sugammadex significantly reduced POD-I compared with neostigmine (risk ratio (RR), 0.67; 95% confidence interval (CI), 0.49-0.91; I2 = 0%; P = .008). Subgroup analysis of RCTs on POD-I within the 1st 24 hours postoperatively showed a significantly lower incidence in the sugammadex group (RR, 0.64; 95% CI, -0.45 to 0.90; P = .010). Subgroup analysis of RCTs by coadministered anticholinergics did not significantly influence POD-I (atropine: RR, 0.67; P = .06; glycopyrrolate: RR, 0.66; P = .06). In contrast, subgroup analysis of NRCTs on POD-I showed no significant difference between the groups (RR, 1.15; 95% CI, 0.88-1.50; I2 = 82%; P = .33). Preoperative and postoperative Mini-Mental State Examination scores in RCTs were similar between groups (preoperative: mean difference 0.03, P = .78; postoperative: mean difference 0.75, P = .12).
conclusionSugammadex is associated with a reduced incidence of POD compared to neostigmine, particularly within the 1st 24 hours after surgery, based on consistent findings from RCTs. This benefit was not observed in NRCTs. Further well-designed RCTs using standardized delirium assessments are required.
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