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Intraoperative neuromuscular block with rocuronium or vecuronium can be reversed with neostigmine or sugammadex. Side effects can occur with both drugs, but their relative safety has been unknown. In a retrospective review of adverse events in 90,000 surgical patients who received reversal, the incidence of a composite of clinically meaningful adverse events (ie, bronchospasm, anaphylaxis, bradycardia, cardiac arrest) was slightly greater with sugammadex than neostigmine (3.4 versus 3.0 percent) [1]. This difference was primarily related to an increase in bronchospasm and...