The Efficacy And Safety Of Sugammadex For Reversing Neuromuscular Blockade Induced By Rocuronium In Pediatric Patients A Meta-analysis

Objective:This Meta-analysis was aimed to evaluate the safety and efficacy of sugammadex to reverse neuromuscular blockade induced by rocuronium in pediatric patients by comparing it with the current common regimen.Method:A literature search was performed using the Cochrane Library,Pubmed,Embase,CNKI,wanfang database,and the retrieval date were up to December 2020.All clinical randomized controlled trials on the efficacy and safety of sugammadex for reversing neuromuscular blockade induced by rocuronium in pediatric patients were collected.The steps of screened the literature,traced the references,evaluated the literature quality,assessed the risk of bias,and extracted the data were all carried out independently by three researchers.To prevent lower-level statistical errors,after each step was completed,three researchers need to check the results drawn by the other.The statistical analysis software Review Manager 5.3 was used for data analysis.Result:A total of 14 clinical RCT studies containing 766 patients were included.The results of the study showed that:（i）The mean time taken to reach a train-of-four ratio of≥0.9 was significantly shorter in the sugammadex groups(2 mg·kg^-1and 4 mg·kg^-1)than that in the control group（MD=-5.60,95%CI-7.51 to-3.69,P<0.00001;MD=-14.16,95%CI-18.85 to-9.46,P<0.00001）;（ii）The extubation time in the sugammadex group(2 mg·kg^-1)was obviously shorter than that in the control group（MD=-4.98,95%CI-7.02～-2.93,P<0.00001）;（iii）The incidence of postoperative adverse reactions was lower in the sugammadex sodium group than in the control group,with a statistically significant difference between the two groups（RR=0.28,95%CI 0.16-0.47,P<0.00001）;The incidence of nausea and vomiting and tachycardia was lower in the sugars glucose sodium group than in the control group（RR=0.24,95%CI 0.11-0.53,P=0.0004;RR=0.11,95%CI 0.03-0.35,P=0.0002）;The difference in the incidence of chills and respiratory depression between the two groups was not statistically significant（RR=1,95%CI 0.33 to 3.02,P=0.50;RR=0.71,95%CI 0.15 to3.47,P=0.68）;Other adverse effects such as bradycardia,excessive sweating,and dry mouth could not be analyzed as only 1 included study was available.Conclusion:Sugammadex,Compared to the current common regimen or placebo,was shown to be rapid,effective and relatively safe in reversing neuromuscular blockade induced by rocuronium in pediatric patients.