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Evidence-based Recommendations for the Use of Neostigmine Versus Sugammadex in Patients Undergoing Thoracic Surgery

Dvorakevych, Ostap
http://rave.ohiolink.edu/etdc/view?acc_num=otbn1713688583505558

Abstract Details

2025, DNP, Otterbein University, Nursing.
Neuromuscular blocking agents play a vital role in the safe delivery of modern anesthetic practice. These medications provide patient paralysis for anesthesia staff to perform tracheal intubation and for surgeons to have a motionless surgical field. At the end of surgery, the effects of these paralytic agents must be fully reversed by reversal agents. Incomplete reversal impairs the patient’s ability to maintain an airway, which can lead to various postoperative pulmonary complications such as respiratory failure, pneumonia, and atelectasis. Patients undergoing thoracic surgery are at high risk for this incomplete reversal due to deep levels of paralysis required to keep the diaphragm motionless for surgical manipulation. Therefore, optimal paralytic reversal strategies must be analyzed and incorporated into clinical practice to decrease residual paralysis and subsequent complications. Neostigmine has traditionally been the primary agent used for paralytic reversal. However, a newer alternative is available with the relatively recent introduction of Sugammadex. Literature has shown that in patients undergoing thoracic surgery, utilizing Sugammadex for reversal of neuromuscular blockade, compared to Neostigmine, improves patient outcomes by reducing postoperative pulmonary complications. This evidence-based practice project evaluates the most up-to-date literature to identify, plan, and implement recommendations for an optimal paralytic reversal strategy in patients undergoing thoracic surgery at a level-one trauma center in the Midwest United States.
Brian Garrett, CRNA, DNP (Advisor)
Brian Garrett, CRNA, DNP (Committee Member)
Amy Bishop, DNP, AGCNS-BC (Committee Member)
Danielle Winch, CRNA, DNP (Committee Member)
53 p.
Medicine; Nursing
Neuromuscular blocking agents; Rocuronium; neuromuscular reversal agents; Sugammadex; Neostigmine; postoperative pulmonary complications

Recommended Citations

Citations

  • Dvorakevych, O. (2025). Evidence-based Recommendations for the Use of Neostigmine Versus Sugammadex in Patients Undergoing Thoracic Surgery [Doctoral dissertation, Otterbein University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=otbn1713688583505558

    APA Style (7th edition)

  • Dvorakevych, Ostap. Evidence-based Recommendations for the Use of Neostigmine Versus Sugammadex in Patients Undergoing Thoracic Surgery. 2025. Otterbein University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=otbn1713688583505558.

    MLA Style (8th edition)

  • Dvorakevych, Ostap. "Evidence-based Recommendations for the Use of Neostigmine Versus Sugammadex in Patients Undergoing Thoracic Surgery." Doctoral dissertation, Otterbein University, 2025. http://rave.ohiolink.edu/etdc/view?acc_num=otbn1713688583505558

    Chicago Manual of Style (17th edition)

otbn1713688583505558
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This open access ETD is published by Otterbein University and OhioLINK.