doi:10.23736/S0375-9393.20.14589-9engSerrano, A.B.Díaz-Cambronero, O.Melchor-Ripollés, J.Abad-Gurumeta, A.Ramírez-Rodríguez, J.M.Martínez-Ubieto, J.Sánchez-Merchante, M.Rodríguez, R.Jordá, L.Gil-Trujillo, S.Cabellos-Olivares, M.Bordonaba-Bosque, D.Aldecoa, C.Neuromuscular blockade management and postoperative outcomes in enhanced recovery colorectal surgery: secondary analysis of POWER trialART-2021-123344BACKGROUND: We evaluated the impact of neuromuscular blockade (NMB) management, monitoring and reversal on postoperative outcomes in colorectal surgical patients included in an enhanced recovery program. METHODS: We performed a predefined analysis in 2084 patients undergoing elective colorectal surgery who participated in POWER study. We analyzed them for complications, length of hospital stay and mortality. Two groups were defined: 1) monitoring + reversal of the neuromuscular blockade (M+R) group: all patients receiving neuromuscular blockade monitoring plus reversal of it with any drug (neostigmine or sugammadex) were included; and 2) no monitoring nor reversal (noM+noR) group. In this group all the patients who did not receive monitoring and reversal of the neuromuscular blockade were allocated. RESULTS: Multivariate analysis found no statistically significant differences in moderate-severe complications (174 [25.7%] vs. 124 [27.1%]; P=0.607), length of hospital stay (10.8±11.1 vs. 11.0 ±12.6 days; P=0.683) and mortality (6 [0.9%] vs. 5 [1.1%]; P=0.840) between the group receiving optimal neuromuscular management (M+R) and the one did not receive it (noM+noR). Univariate analysis showed patients reversed with neostigmine died more than those reversed with sugammadex (3 [2.7%] vs. 3 [0.5%]; P=0.048). CONCLUSIONS: Our data suggest optimal neuromuscular blockade management in colorectal surgery is not associated with less moderate-severe complications, length of hospital stay or death during postoperative period in an enhanced recovery program. Neostigmine reversal seems to be linked to higher rate of mortality than sugammadex.2021http://zaguan.unizar.es/record/13047010.23736/S0375-9393.20.14589-9http://zaguan.unizar.es/record/130470oai:zaguan.unizar.es:130470Minerva Anestesiologica 87, 1 (2021), 13-25All rights reservedhttp://www.europeana.eu/rights/rr-f/info:eu-repo/semantics/closedAccess