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Pre-planned sub-studies of the SNaPP multi-centre randomised controlled trial

Project Grant

The SNaPP Study recently concluded recruitment, randomising 3,500 patients across 44 metropolitan, regional and private hospitals in Australia, Aotearoa New Zealand and Hong Kong. Patients aged ≥40 years having abdominal and thoracic surgery were randomised to neostigmine or sugammadex reversal of neuromuscular blockade, with primary outcome the incidence of death and new lung complications up to hospital discharge (or postoperative day 7 if still in hospital). Results of the main trial will be published early in 2026. 

This grant will support sub-studies investigating issues that are important to patients. The PONV sub-study will determine whether neostigmine is associated with more nausea and vomiting than sugammadex, so that it can be avoided in patients who are at high risk, potentially improving length of stay, resource allocation, cost, and quality of life. The Frailty sub-study will examine whether frailty and other factors, such as older age and lung disease, increase the risk of lung complications after surgery. The Follow-up sub-study will look at the effect of the reversal agents and postoperative lung complications on survival one year after surgery. 

Associate Professor Jai Darvall, Professor Kate Leslie, Royal Melbourne Hospital and the University of Melbourne, Professor Matthew Chan, Chinese University of Hong Kong, Dr Peter Xiang, Auckland District Health Board, New Zealand, Associate Professor Sabine Braat, The University of Melbourne. 

The project was awarded A$69,820 funding through the ANZCA research grants program for 2026.