Discussion
pneumonia, postoperative pulmonary complications, peristalsis, Postoperative pulmonary complication, Early postoperative neuromuscular recovery, gastrointestinal motility
PNEUMONIA, COMPLICATION OF ANESTHESIA, DELAYED RECOVERY FROM ANESTHESIA, POSTOPERATIVE COMPLICATIONS
Our study demonstrated that intraoperative administration of sugammadex significantly reduced the time to passage of flatus or feces and dramatically reduced PACU length of stay. However, there was no impact on the length of postoperative hospital stay.The results of our study suggested that sugammadex has a significant effect on the recovery of gastrointestinal motility concurrent with previous studies [Nevertheless, in our study, people in sugammadex group received less opioids as compared to the spontaneously recovered group, Although remifentanil is a ultrashort effect opioid, considering the adverse gastrointestinal effects of opioid use [We did not use the conventional drugs such as neostigmine as the control treatment. Neostigmine can promote intestinal peristalsis by the inhibition of acetylcholinesterase [Brueckmann et al. [Although our results indicated that administration of sugammadex effected the early recovery of bowel function and contributed to the efficiency of PACU turn over, there was no difference in length of postoperative hospital stay between the sugammadex and spontaneous recovery groups in our study. This conclusion is currently debatable because it is not concurrent with the reported results of other studies. A recent retrospective study with a large sample size reported a trend toward a shorter hospital stay and lower rate of 30-day readmissions after administration of sugammadex for NMB reversal in patients undergoing major abdominal surgery [Consistent with the aforementioned results, our analysis revealed that pancreatic surgery and hepatobiliary resection contributed to increased length of hospital and PACU stays, though these durations were significantly shorter in laparoscopy than in open surgery. However, we did not conduct an accurate evaluation for different surgical sites and specific surgical approaches; hence, the differences in the results can be attributed to this reason. Factors such as social norms, reimbursement models, and the availability of reliable rehabilitation systems remain important parameters for length of stay. Thus, postoperative hospital stays partially reflect postoperative recovery [Early postoperative neuromuscular recovery with inadequate NMB is a frequent complication of anesthesia. This period was associated with either postoperative complications or intensive care unit stay following delayed recovery from anesthesia [Postoperative pulmonary complication rate and average time from operation to discharge were reported to be significantly reduced in patients administered sugammadex than those administered pyridistigmine [Our study presents newer data that sugammadex minimizes residual NMB and results in a decreased incidence of pneumonia, but it could not reduce the incidence of other postoperative pulmonary complications. The conclusions from various studies are not uniform, because there are many mixed influencing factors such as type of surgical procedure, the patient’s own conditions, consumption of perioperative opioids, difference of surgical and anaesthetic techniques, which can all influence the incidence of postoperative pulmonary complications. Further studies are required to verify the beneficial effect of sugammadex on clinical respiratory outcomes.Our study has some limitations. First, since this single-center study was conducted with a relatively small sample size, it is not fully representative of the groups as a whole. Therefore, future multicenter prospective studies with a large sample size are necessary. Second, only patients who had undergone abdominal surgery were included in the study and opioid may also has the potential for a certain impact on intestinal motility. Third, the long-term effects of surgery on postoperative outcomes were not observed. Therefore, future retrospective studies are needed to validate these results.