Sugammadex versus neostigmine for postoperative nausea and vomiting in adult patients undergoing laparoscopic surgery paralyzed with rocuronium bromide: a systematic review protocol.

Objectives: The objective of this review is to determine if the occurrence of post-operative nausea and vomiting (PONV) is affected by using sugammadex or neostigmine, in adult patients undergoing laparoscopic procedures paralyzed by rocuronium bromide.

Introduction: Laparoscopic procedures significantly increase the occurrence of PONV in patients. The focus should be on preventing the occurrence of PONV. Laparoscopic procedures use neo-muscular blocking agents to assist with creation of a pneumoperitoneum. After the procedure is complete, reversal of these agents is critical for patient recovery. Understanding the effects for each of the reversal medications is important for future decisions for peri-operative care.

Inclusion criteria: This review will consider studies with patients aged 18 and older, undergoing laparoscopic procedures, paralyzed with rocuronium.

Methods: A search for relevant published and unpublished literature will be conducted in MEDLINE, CINAHL, Embase, Scopus, ClinicalTrials.gov and Cochrane Central Register of Controlled Trials (CENTRAL), in addition to gray literature sources. Articles that meet the inclusion criteria will be further assessed for methodological validity by two independent reviewers using standardized critical appraisal instruments. Data will be extracted from papers included in the review using a standardized data extraction tool. Quantitative data will be pooled for statistical meta-analysis to evaluate the occurrence of PONV with both sugammadex and neostigmine.