Neostigmine and sugammadex are two medications used to reverse the neuromuscular blockade caused by nondepolarizing aminosteroidal neuromuscular blocking agents. Research has shown an association between the use of acetylcholinesterase inhibitors, such as neostigmine, and residual neuromuscular blockade in pediatric patients. Sugammadex has been shown to reduce residual neuromuscular blockade in adults without adverse effects, but minimal research has been performed on the effects of sugammadex in the pediatric population. Therefore, the objective of the present study is to compare sugammadex and neostigmine to determine if using sugammadex instead of neostigmine reduces postoperative adverse effects in the pediatric population. A systematic, computerized search was conducted on PubMed, MEDLINE, EMBASE, and the Cochrane Library, as well as the clinical trials registries: www.controlled-trials.com and clinicaltrials.gov. Studies comparing sugammadex versus neostigmine in the pediatric population receiving nondepolarizing neuromuscular blocking agents were included. The present study shows that sugammadex rapidly and efficiently reverses neuromuscular blockade in the pediatric population with less adverse effects than neostigmine. Furthermore, it has been found to be as safe and effective in the pediatric population as in the adult population
