Major study uncovers ‘hidden pandemic’ of lung complications after surgery

A major international study involving New Zealand patients and hospitals has uncovered what researchers are calling a hidden pandemic of lung complications after surgery.

The four-year trial involved nearly 3,500 patients across 44 hospitals in Australia, New Zealand and Hong Kong, including more than 400 participants from this country.

Researchers compared two drugs used to reverse muscle relaxants administered during surgery and examined their impact on post-operative lung complications.

Associate Professor Jay Darvall, an intensive care specialist and anaesthetist at the Royal Melbourne Hospital and the University of Melbourne, said the findings highlighted a largely unseen but significant problem.

While patients often focused on pain, nausea and mobility during recovery, Darvall said clinicians had long been aware of post-operative pulmonary complications, including pneumonia and lung collapse, known as atelectasis.

The study found 19 per cent of patients who received a newer drug, sugammadex, experienced a post-operative pulmonary complication, compared with 21.5 per cent of those given an older drug, neostigmine.

Researchers said the benefit was largely driven by a reduction in atelectasis, a condition in which parts of the lung collapse, reducing the body’s ability to exchange oxygen and increasing the risk of further respiratory problems.

More than 300 million people undergo surgery worldwide each year, and researchers estimated tens of millions receive muscle-relaxing drugs that required reversal before recovery.

Darvall said he had been surprised by how common the complications were.

“One fifth of patients having post-operative pulmonary complications really is a significant number,” he said.

The researchers said the findings provided strong evidence supporting the use of sugammadex as the preferred reversal agent, although the drug remained more expensive and less accessible in some parts of the world.

They said the results could help inform future health policy decisions and improve access to medications that reduce complications after surgery.

The study included researchers from across Australia and New Zealand, with Professor Tim Short of the University of Auckland serving as the lead New Zealand investigator.

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