Effect of neostigmine antagonizing non-depolarizing muscle relaxants on postoperative pulmonary complications in patients after lobectomy：a retrospective cohort study

Abstract

Objective To investigate the effect of neostigmine, which was used to antagonistic muscle relaxant, on the incidence of postoperative pulmonary complications (PPCs) in patients with lobectomy. Methods This is a retrospective cohort study using electronic medical information and telephone followed-up information of patients who admitted in the thoracic surgery department, the People’s Hospital of Jianyang from Jun 2021 to May 2022. All patients were divided into 2 groups according to whether PPCs occurred or not: Neostigmine antagonists (NEO group) and non-Neostigmine antagonists (N group). The outcomes of the two groups were compared with the T-test, Mann-Whitney U test and Pearson Chi-square test. Results A total of 227 patients were analyzed, there was no significant difference in baseline data between the two groups (P > 0.05); the incidence of PPCs during postoperative hospitalization was significantly different between the two groups (𝛘² = 4.143, P = 0.042 < 0.05); 30 days after discharge, there was no significant difference in the incidence of PPCs between the two groups (𝛘2, 0.715, P = 0.398 > 0.05); there was no significant difference in the length of hospital stay between the two groups (Wilcoxon rank sum test, Z = 0.411, P = 0.681 > 0.05);there was no significant difference between the two groups (F = 0.404, P = 0.668 > 0.05) of Steward scores at 10min (T1), 30min (T2) and 60min (T3) after tracheal catheter removal; there was no significant difference in PACU residence time between the two groups (Z = 0.954, P = 0.340 > 0.05). Conclusions In patients with elective lobectomy, the postoperative choice of neostigmine for muscle loosening antagonism can reduce the incidence of PPCs during postoperative hospitalization, but it has no effect on the incidence of PPCs within 30 days after surgery.