Sugammadex in comparison to neostigmine for reversal of neuromuscular blocking agents in adult patients undergoing surgery: a scoping review protocol

Objective: The objective of this scoping review is to understand the extent and nature of evidence from randomised controlled trials comparing sugammadex with neostigmine for reversal of neuromuscular blocking agents in adult patients undergoing surgery. Introduction: Over 3 million NHS patients undergo general anaesthesia each year, with complications being common and associated with increased hospital stays, long-term health issues, and higher mortality. Of these, post-operative pulmonary complications are the most frequent, affecting over 230,000 patients annually and costing the NHS more than £280 million. While many risk factors for post-operative pulmonary complications are non-modifiable, such as age and pre-existing lung disease, one major modifiable anaesthesia-related factor relates to the use and reversal of neuromuscular blocking agents. Inclusion criteria: The population is adult patients undergoing surgery with neuromuscular blockade. The concept is use of sugammadex vs neostigmine in relation to the patient-centred outcomes, and the context is that studies will be included irrespective of geographic location, healthcare setting, patient population or type of surgery, provided they meet eligibility for population and concept. Methods: This review follows Joanna Briggs Institute methodology for scoping reviews and adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews Checklist. This approach helps to enhance transparency and uniformity of reporting scoping reviews and can help to improve the quality and value of a scoping review to readers and end users. The databases to be searched are Medline and Embase, and the registries to be searched are Cochrane Register of Clinical Trials and International Standard Randomised Controlled Trial Number Registry. The search will be limited to the English language. Study selection will be based on pre-defined inclusion criteria. Data will be extracted using a pre-defined data charting table. The outlined scoping review will provide a synthesis of the literature, to map current evidence and inform future research in this area.