Impact of Sugammadex Versus Neostigmine on Early Postoperative Pulmonary Function

Recruiting now · Not applicable

Conditions studied: Residual Neuromuscular Block

In brief

Residual neuromuscular blockade (NMB) after general anesthesia increases the risk of postoperative respiratory complications (atelectasis, pneumonia, re-intubation) and delays pulmonary function recovery. Sugammadex, a γ-cyclodextrin that directly encapsulates rocuronium, reverses NMB rapidly and completely without cholinergic side effects, whereas neostigmine requires co-administration of an antimuscarinic and may leave residual blockade. In this multicenter, randomized, double-blind, controlled trial, 240 adult patients (ASA I-III) undergoing elective thoracoscopic lung resection (≤ 1 segment) will be randomized 1:1 to receive sugammadex (2 mg/kg) or neostigmine (0.03 mg/kg) + atropine (0.015 mg/kg) at the end of surgery. The primary endpoint is the percent decline in forced expiratory volume in 1 second (FEV₁) at 1 hour post-extubation compared to preoperative baseline; a ≥ 5% improvement with sugammadex is hypothesized. Secondary endpoints include FEV₁ at days 1-3, pain scores, opioid consumption, gastrointestinal recovery, quality of recovery (QoR-15), neuromuscular monitoring (TOF ratio), and incidence of postoperative pulmonary and surgical complications.

Key facts

Study ID: NCT07309393
Run by: Shanghai Pulmonary Hospital, Shanghai, China
People needed: 240
Starts: 2025-12-30
Expected to finish: 2026-09-30
Last updated by the study team: 2026-06-22

Who can join

Age: 18 and older, up to 80. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

Scheduled for elective unilateral thoracoscopic partial lung resection, with expected resection not exceeding one lung segment.
Age between 18 and 80 years.
American Society of Anesthesiologists (ASA) Physical Status classification I-III.

You may not qualify if…

Contraindications to drug use, such as history of allergy, epilepsy, angina, ventricular tachycardia; contraindicated in patients with mechanical intestinal obstruction or urinary tract obstruction; contraindicated in cases of arrhythmia, bradycardia (<50 beats per minute), hypotension, or increased vagal tone; contraindicated in patients currently using depolarizing muscle relaxants (e.g., succinylcholine).
Inability to correctly cooperate with portable lung function testing.
Hepatic or renal insufficiency.
Pregnancy, lactation, potential for pregnancy, or planning pregnancy.
Preoperative history of drug abuse or addiction.
Second surgery during postoperative hospitalization.
Patients who refuse to participate.
Other situations deemed inappropriate by the investigators shall be accompanied by a statement of the reasons.

Where it is running

Shanghai Pulmonary Hospital — Shanghai, Shanghai Municipality, China (enrolling)
Shanghai East Hospital,Affiliated to Tongji University — Shanghai, Shanghai Municipality, China (enrolling)
Fudan university Shanghai cancer center — Shanghai, Shanghai Municipality, China (enrolling)

Full record on ClinicalTrials.gov

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