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Effects of sugammadex on coagulation: a systematic review and meta-analysis

Yu-Hsun Tsai, Ming‐Chang Kao, H A Kao

2025BMC Anesthesiology6 citationsDOIOpen Access PDF

Abstract

BACKGROUND: Sugammadex, an innovative agent that rapidly and completely reverses rocuronium-induced neuromuscular blockade, may prolong coagulation time and influence postoperative bleeding. This study aimed to investigate the effects of sugammadex on coagulation parameters. METHODS: Cochrane Central Register of Controlled Trials, Embase, and PubMed were searched on September 25, 2024, for randomized control trials (RCTs) examining the impact of sugammadex on coagulation time. RESULTS: Five RCTs involving 1328 participants were included. Four RCTs with 1302 participants provided data for the meta-analysis. Sugammadex was found to prolong prothrombin time (PT) without affecting activated partial thromboplastin time (APTT). CONCLUSIONS: Sugammadex administration may transiently increase PT values without affecting the APTT. Routine coagulation monitoring is not required in healthy individuals; however, individualized assessment should be conducted in high-risk patients. Further studies are warranted to evaluate the coagulation effects of sugammadex in patients with coagulopathies or those receiving anticoagulant therapy. TRIAL REGISTRATION: This study is registered in the PROSPERO database under the ID CRD42024604567.

Topics & Concepts

AnesthesiologyMedicineSugammadexMeta-analysisCoagulationPain medicineIntensive care medicineAnesthesiaRocuroniumInternal medicineIntubationAnesthesia and Sedative AgentsTrauma, Hemostasis, Coagulopathy, ResuscitationAtrial Fibrillation Management and Outcomes