Residual neuromuscular block in paediatric anaesthesia
| Authors | |
|---|---|
| Year of publication | 2019 |
| Type | Article in Periodical |
| Magazine / Source | British Journal of Anaesthesia |
| MU Faculty or unit | |
| Citation | |
| Web | http://dx.doi.org/10.1016/j.bja.2018.10.001 |
| Doi | http://dx.doi.org/10.1016/j.bja.2018.10.001 |
| Keywords | neuromuscular blockade; paediatric anaesthesia; residual blockade |
| Description | Background: Residual neuromuscular blockade (RNB) in postoperative period is frequent (26-88%) and it is associated with negative impact on perioperative morbidity. The safety cut-off measured by accelerometry is currently defined as Train-of-four ratio (TOFr) >= 0.9. The primary outcome of the study was detect the incidence of RNB measured just prior extubation in the operating room (OR) (according to pragmatic trial design) and the secondary outcome was the incidence of the RNB in postanaethesia care unit (PACU). Methods: After Ethics Committee (10/2016) approval, paediatric patients (1.1.2017-31.12.2017) undergoing surgery in general anaesthesia with muscle relaxation were included in the study. The level of blockade was measured just prior to extubation in OR (patient eligible for extubation according to the anesthesiologist) and after arrival at PACU with acceleromtery – TOF-Watch®SX (Organon, Inc, West Orange, NJ). The mode for measurement was Train-of-four (TOF) and Train-of-four ratio (TOFr), in case of deep blockade Post-tetanic count (PTC). Data are described by descriptive analytic methods (mean, standard deviation -SD, median). Results: Overall, 291 patients were included in the study. The incidence of RNB in the OR was 48.2 % (95% CI: 42.4 54.1%, n=136) and the incidence of RNB in PACU was 26.9 % (95% CI: 19.5 35.3 %, n = 32). Active block reversal was administered in 23.3% (n=68) patients. Overall, 31.6% (87/275) patients were extubated with TOFr<0.9. Conclusion: Residual neuromuscular blockade in selected cohort of paediatric patients was frequent. |
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