Optimizing recovery in orthognathic surgery: the cohort study of impact of rocuronium–sugammadex on extubation and perioperative outcomes
Background Orthognathic surgery (OGS) often necessitates deep neuromuscular blockade to optimize surgical conditions, but the choice of neuromuscular blocking and reversal agents may influence postoperative recovery. Rocuronium, when reversed with sugammadex, offers rapid neuromuscular recovery comp...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2025-12-01
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| Series: | Annals of Medicine |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/07853890.2025.2536201 |
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| author | Shao-Chun Wu Tsung-Yu Wang Amina M. Illias Yung-Fong Tsai Yi-Ping Wang Ying-An Chen Chun-Yu Wu |
| author_facet | Shao-Chun Wu Tsung-Yu Wang Amina M. Illias Yung-Fong Tsai Yi-Ping Wang Ying-An Chen Chun-Yu Wu |
| author_sort | Shao-Chun Wu |
| collection | DOAJ |
| description | Background Orthognathic surgery (OGS) often necessitates deep neuromuscular blockade to optimize surgical conditions, but the choice of neuromuscular blocking and reversal agents may influence postoperative recovery. Rocuronium, when reversed with sugammadex, offers rapid neuromuscular recovery compared to traditional cisatracurium and neostigmine. This study evaluates the impact of rocuronium/sugammadex versus cisatracurium/neostigmine on perioperative outcomes in OGS.Methods This retrospective cohort study analyzed 361 patients who underwent OGS between 2019 and 2022. Patients received either cisatracurium with neostigmine (n = 284) or rocuronium with sugammadex (n = 77). The primary outcome was extubation time. Secondary outcomes included hospital length of stay, intraoperative blood loss, anesthetic consumption, opioid requirements, and hemodynamic stability. Multiple logistic regression identified predictors of delayed extubation.Results Patients in the rocuronium/sugammadex group demonstrated significantly shorter extubation times (25.0 [15.0–77.5] vs. 55.0 [25.0–85.0] min, p = 0.002) and reduced hospital stays (3 [3–5] vs. 4 [4–5] days, p = 0.003). They also exhibited lower inhalational anesthetic consumption (p = 0.002), reduced surgical blood loss (p = 0.046), and shorter hypotension duration (p = 0.017), albeit with increased intraoperative opioid requirements (p < 0.001). Logistic regression identified sugammadex use as an independent protective factor against delayed extubation (OR = 0.26, 95% CI: 0.13–0.50, p < 0.001).Conclusions The use of rocuronium with sugammadex in OGS is associated with enhanced postoperative recovery, including reduced extubation time, decreased intraoperative blood loss, and shorter hospital stay. |
| format | Article |
| id | doaj-art-e65848179aaa49a594aada547244962f |
| institution | Kabale University |
| issn | 0785-3890 1365-2060 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Annals of Medicine |
| spelling | doaj-art-e65848179aaa49a594aada547244962f2025-08-20T03:51:18ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602025-12-0157110.1080/07853890.2025.2536201Optimizing recovery in orthognathic surgery: the cohort study of impact of rocuronium–sugammadex on extubation and perioperative outcomesShao-Chun Wu0Tsung-Yu Wang1Amina M. Illias2Yung-Fong Tsai3Yi-Ping Wang4Ying-An Chen5Chun-Yu Wu6Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, TaiwanDepartment of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, TaiwanGraduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, TaiwanGraduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, TaiwanDepartment of Anesthesiology, National Taiwan University Hospital Hsinchu Branch, Hsinchu City, TaiwanDepartment of Anesthesiology, National Taiwan University Hospital Hsinchu Branch, Hsinchu City, TaiwanDepartment of Anesthesiology, National Taiwan University Hospital Hsinchu Branch, Hsinchu City, TaiwanBackground Orthognathic surgery (OGS) often necessitates deep neuromuscular blockade to optimize surgical conditions, but the choice of neuromuscular blocking and reversal agents may influence postoperative recovery. Rocuronium, when reversed with sugammadex, offers rapid neuromuscular recovery compared to traditional cisatracurium and neostigmine. This study evaluates the impact of rocuronium/sugammadex versus cisatracurium/neostigmine on perioperative outcomes in OGS.Methods This retrospective cohort study analyzed 361 patients who underwent OGS between 2019 and 2022. Patients received either cisatracurium with neostigmine (n = 284) or rocuronium with sugammadex (n = 77). The primary outcome was extubation time. Secondary outcomes included hospital length of stay, intraoperative blood loss, anesthetic consumption, opioid requirements, and hemodynamic stability. Multiple logistic regression identified predictors of delayed extubation.Results Patients in the rocuronium/sugammadex group demonstrated significantly shorter extubation times (25.0 [15.0–77.5] vs. 55.0 [25.0–85.0] min, p = 0.002) and reduced hospital stays (3 [3–5] vs. 4 [4–5] days, p = 0.003). They also exhibited lower inhalational anesthetic consumption (p = 0.002), reduced surgical blood loss (p = 0.046), and shorter hypotension duration (p = 0.017), albeit with increased intraoperative opioid requirements (p < 0.001). Logistic regression identified sugammadex use as an independent protective factor against delayed extubation (OR = 0.26, 95% CI: 0.13–0.50, p < 0.001).Conclusions The use of rocuronium with sugammadex in OGS is associated with enhanced postoperative recovery, including reduced extubation time, decreased intraoperative blood loss, and shorter hospital stay.https://www.tandfonline.com/doi/10.1080/07853890.2025.2536201Delayed extubationorthognathic surgerysugammadex |
| spellingShingle | Shao-Chun Wu Tsung-Yu Wang Amina M. Illias Yung-Fong Tsai Yi-Ping Wang Ying-An Chen Chun-Yu Wu Optimizing recovery in orthognathic surgery: the cohort study of impact of rocuronium–sugammadex on extubation and perioperative outcomes Annals of Medicine Delayed extubation orthognathic surgery sugammadex |
| title | Optimizing recovery in orthognathic surgery: the cohort study of impact of rocuronium–sugammadex on extubation and perioperative outcomes |
| title_full | Optimizing recovery in orthognathic surgery: the cohort study of impact of rocuronium–sugammadex on extubation and perioperative outcomes |
| title_fullStr | Optimizing recovery in orthognathic surgery: the cohort study of impact of rocuronium–sugammadex on extubation and perioperative outcomes |
| title_full_unstemmed | Optimizing recovery in orthognathic surgery: the cohort study of impact of rocuronium–sugammadex on extubation and perioperative outcomes |
| title_short | Optimizing recovery in orthognathic surgery: the cohort study of impact of rocuronium–sugammadex on extubation and perioperative outcomes |
| title_sort | optimizing recovery in orthognathic surgery the cohort study of impact of rocuronium sugammadex on extubation and perioperative outcomes |
| topic | Delayed extubation orthognathic surgery sugammadex |
| url | https://www.tandfonline.com/doi/10.1080/07853890.2025.2536201 |
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