eISSN: 1731-2531
ISSN: 1642-5758
Anaesthesiology Intensive Therapy
Current issue Archive Manuscripts accepted About the journal Supplements Editorial board Reviewers Abstracting and indexing Subscription Contact Instructions for authors Publication charge Ethical standards and procedures
Editorial System
Submit your Manuscript
SCImago Journal & Country Rank
vol. 55
Letter to the Editor

Commentary on “An appraisal of neostigmine versus sugammadex for neuromuscular blockade reversal in patients with a prior heart transplant”

Sumit Roy Chowdhury
Dalim Kumar Baidya

Department of Neuroanesthesiology and Critical Care, All India Institute of Medical Sciences, New Delhi, India
Department of Anesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India
Anaesthesiol Intensive Ther 2023; 55, 3: 240
Online publish date: 2023/08/25
Article file
Get citation
PlumX metrics:

Dear Editor,

The article by Paredes et al. [1] is interesting and has intrigued us. With the increasing number of cardiac transplants worldwide, this article presents a meaningful conclusion. There is a lot of recent evidence suggesting that the incidence of post-operative pulmonary complications (POPC) is lower with the use of sugammadex as compared to neostigmine [2, 3]. Pulmonary complications are frequent after cardiac transplant [4], and it is not illogical to assume that post-cardiac transplant patients may be prone to develop POPC. Renal impairment is another common setback in the post-transplant period in these patients [5]. Were both the groups comparable in terms of renal and pulmonary status? Although sugammadex has been safely used in patients with end-stage renal disease, the safety profile in this subgroup is yet not fully established [6]. Is it possible that the associated renal dysfunction has contributed to a longer length of stay in these patients? Do the authors have the data to compare the incidence of POPC between sugammadex and neostigmine groups? We again congratulate them for this invaluable finding. The additional analysis, in our opinion, would make the article still more resourceful.


Assistance with the article


Financial support and sponsorship


Conflicts of interest






Paredes S, Torres V, Chaves-Cardona H, Matus M, Porter S, Renew J. An appraisal of neostigmine versus sugammadex for neuromuscular blockade reversal in patients with a prior heart transplant. Anaesthesiol Intensive Ther 2023; 55: 241-242. doi: 10.5114/ait.2023.130640.


Kheterpal S, Vaughn MT, Dubovoy TZ, et al. Sugammadex versus neostigmine for reversal of neuromuscular blockade and postoperative pulmonary complications (STRONGER): a multicenter matched cohort analysis. Anesthesiology 2020; 132: 1371-1381. doi: 10.1097/ALN.0000000000003256.


Wu EB, Huang SC, Lu HI, et al. Use of rocuronium and sugammadex during video-assisted thoracoscopic surgery is associated with reduced duration of chest-tube drainage: a propensity score-matched analysis. Br J Anaesth 2023; 130: e119-e127. doi: 10.1016/j.bja.2022.07.046.


Lenner R, Padilla ML, Teirstein AS, Gass A, Schi-lero GJ. Pulmonary complications in cardiac transplant recipients. Chest 2001; 120: 508-513. doi: 10.1378/chest.120.2.508.


Roest S, Hesselink DA, Klimczak-Tomaniak D, et al. Incidence of end-stage renal disease after heart transplantation and effect of its treatment on survival. ESC Heart Failure 2020; 7: 533-541. doi: 10.1002/ehf2.12585.


Staals LM, Snoeck MMJ, Driessen JJ, Flockton EA, Heeringa M, Hunter JM. Multicentre, parallel-group, comparative trial evaluating the efficacy and safety of sugammadex in patients with end-stage renal failure or normal renal function. Br J Anaesth 2008; 101: 492-497. doi: 10.1093/bja/aen216.

This is an Open Access journal, all articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0). License (http://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
Quick links
© 2023 Termedia Sp. z o.o.
Developed by Bentus.