Hafeez KR, et al. - Researchers investigated if obstructive sleep apnea (OSA) patients are at higher risk of postoperative complications from the use of neuromuscular blocking drugs (NMBD) than non-OSA patients and whether the choice of NMBD reversal agent impacts the risk of postoperative complications in OSA patients. They included only randomized controlled trials (RCTs) or observational cohort studies, published in English, involving adult surgical patients (≥18 years old) with OSA diagnosed by polysomnography, or history, or suspected by screening questionnaire and patients who were given NMBD and/or NMBD reversal agents intraoperatively, and reporting on postoperative adverse events, particularly respiratory events. They found that OSA patients who received intraoperative NMBD vs non-OSA patients may be at higher risk for postoperative hypoxemia, respiratory failure and residual neuromuscular blockade. Very limited evidence demonstrated that NMBD reversal with sugammadex vs neostigmine may be related to less postoperative pulmonary complications in patients with OSA.