Correspondence  |   July 2017
Science or Fiction? Risk of Postoperative Pneumonia with Neuromuscular Blockade
Author Notes
  • University of Florida College of Medicine, Gainesville, Florida (R.V.Z.). rzhang@anest.ufl.edu
  • (Accepted for publication April 13, 2017.)
    (Accepted for publication April 13, 2017.)×
Article Information
Correspondence
Correspondence   |   July 2017
Science or Fiction? Risk of Postoperative Pneumonia with Neuromuscular Blockade
Anesthesiology 7 2017, Vol.127, 197. doi:10.1097/ALN.0000000000001697
Anesthesiology 7 2017, Vol.127, 197. doi:10.1097/ALN.0000000000001697
We read with interest the study by Bulka et al.,1  which suggested a higher risk of postoperative pneumonia (POP) after the use of neuromuscular blocking agents (NMBAs). We believe that there are inconsistencies and calculation errors that significantly change the results of their study. In the NMBA analysis, there were 38 POP cases among 1,455 patients from the 10,594 patients who received an NMBA during surgery, yielding a POP incidence rate of 2.6%. However, in the NMBA reversal analysis, these same 10,594 patients were split into two subgroups: 1,623 patients who did not receive reversal and 8,971 patients who were given neostigmine. To our surprise, the POP incidence rates are significantly higher in both subgroups, with 149 POP cases in the 1,320 patients (11.5%) who received NMBA without reversal and 70 POP cases in the 1,320 patients (5.3%) who received NMBA and were reversed with neostigmine. Because these two subgroups are from the same 10,594 patients in the NMBA group, we do not understand why the POP rates are so much higher in the two subgroups.
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