Batistaki C, et al. - This randomised, double-blind controlled trial examined the impacts of sugammadex and neostigmine/atropine on postoperative cognitive dysfunction (POCD) in adult patients after elective surgery. Both agents did not afford clinically important differences in the incidence of POCD.

Methods

• Researchers performed a randomised, double-blind controlled trial on 160 American Society of Anesthesiologists physical status I to III patients who were >40 years.
• They used the Mini–Mental State Evaluation, clock-drawing test and the Isaacs Set test to evaluate cognitive function at three timepoints: preoperatively, one hour postoperatively, and at discharge.
• The anaesthetic protocol was the same for all patients, except for the neuromuscular block reversal, which was administered by random allocation using either sugammadex or neostigmine/atropine after the reappearance of T2 in the train-of-four sequence.
• POCD was defined as a decline ≥1 standard deviation in ≥2 cognitive tests.  

Results

• Findings demonstrated that the incidence of POCD was similar in both groups at one hour postoperatively and at discharge (28% and 10%, in the neostigmine group, 23% and 5.4% in the sugammadex group, P=0.55 and 0.27 respectively).
• In relation to individual tests, researchers observed a significant decline of clock-drawing test in the neostigmine group at one hour postoperatively and at discharge.
• Data revealed that for the Isaacs Set test, a greater decline was found in the sugammadex group.