Sugammadex to prevent postoperative nausea and vomiting?

We read with great interest the article of Yagan et al. in a recent issue of the journal.¹ The authors should be congratulated for performing a well-designed randomized clinical trial. Sugammadex has become a popular drug in perioperative medicine with not only important effects on patients' safety (e.g., residual paralysis) but also on other critical outcomes such as hospital discharge.^2,3

In order to further establish the validity and reproducibility of the study results, we had some questions regarding the trial that require some comments from the authors. First, since the authors used different types of surgical procedures, it would be important to demonstrate that the postoperative opioid consumption was similar between the groups as this can alter the primary outcome.⁴ Secondly, it seems that the authors did not administered routine antiemetic drugs as commonly done in routine practice and recommended by PONV guidelines.^5,6 Finally, it is not clear who collected the data and why the authors did not use a double-blinded design to avoid measurement bias.

We would welcome some comments from the authors. This would help to further establish the significance of this clinical trial in this very important topic.

References

• ¹
  Yağan Ö, Taş N, Mutlu T, Hancı V. Comparison of the effects of sugammadex and neostigmine on postoperative nausea and vomiting. Br J Anaesth. 2017;67:147-52.
• ²
  Herring WJ, Woo T, Assaid CA, et al. Sugammadex efficacy for reversal of rocuronium- and vecuronium-induced neuromuscular blockade: a pooled analysis of 26 studies. J Clin Anesth. 2017;41:84-91.
• ³
  Carron M, Zarantonello F, Lazzarotto N, Tellaroli P, Ori C. Role of sugammadex in accelerating postoperative discharge: a meta-analysis. J Clin Anesth. 2017;39:38-44.
• ⁴
  Gacio MF, Lousame AM, Pereira S, Castro C, Santos J. Paravertebral block for management of acute postoperative pain and intercostobrachial neuralgia in major breast surgery. Br J Anaesth. 2016;66:475-84.
• ⁵
  Yang GZ, Xue FS, Li HX, Liu YY. Perioperative use of 5% dextrose to decrease postoperative nausea and vomiting. J Clin Anesth. 2017;41:63-4.
• ⁶
  Gan TJ, Diemunsch P, Habib AS, et al. Consensus guidelines for the management of postoperative nausea and vomiting. Anesth Analg. 2014;118:85-113.

Publication Dates

• Publication in this collection
  May-Jun 2018