Influence of reversal with sugammadex or neostigmine on postoperative bowel movement following robotic thyroidectomy: a retrospective study

Abstract Background Postoperative bowel dysfunction poses difficulty during recovery, and reversal agents may affect bowel function. The purpose of this study was to determine whether time to first postoperative bowel movement after non-abdominal surgery differs among neuromuscular (NM) blockade reversal with either anticholinesterase/anticholinergic combination or sugammadex. Methods The electronic medical records of 108 patients who underwent robotic thyroidectomy between March 2018 and July 2018 were retrospectively reviewed. The use of agents to reverse NM blockade (neostigmine 1 mg and glycopyrrolate 0.2 mg, or sugammadex 2 mg/kg) was decided by the attending anesthesiologist. Demographic, clinical, and laboratory findings and first gas-passing time after surgery were assessed. Results The median gas passing time after operation was 957.5 min (425–1455) in the neostigmine group and 600 min (310–1080) in the sugammadex group (P = 0.113). Univariate logistic regression analysis indicated that first gas-passing time within 12 h after operation was significantly associated with perioperative use of opioid analgesics (odds ratio = 2.85, 95% confidence interval 1.26–6.43, P = 0.012). Multivariate logistic regression analysis revealed no significant association of reversal agents, perioperative opioid use, or postoperative hypocalcemia with first gas-passing time within 12 h after operation. Conclusions Sugammadex may not cause a delay in postoperative gastric motility compared to neostigmine/glycopyrrolate in patients undergoing robotic thyroidectomy.