Residual neuromuscular blockade and late neuromuscular blockade at the post-anesthetic recovery unit: prospective cohort study
Introduction and objectives: The use of neuromuscular blockers during surgery represented a landmark for anesthesiology. However, their use can prompt residual Neuromuscular Blockade (RNMB) and objective monitoring of neuromuscular function is crucial to warrant the recovery of muscle strength. The...
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| Format: | Article |
| Language: | English |
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Elsevier
2021-01-01
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| Series: | Brazilian Journal of Anesthesiology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0104001420302116 |
| _version_ | 1811227547103395840 |
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| author | Pedro Marcos Silva e Gonçalves Alexandra de Vasconcelos Vieira Claudia Helena Ribeiro da Silva Renato Santiago Gomez |
| author_facet | Pedro Marcos Silva e Gonçalves Alexandra de Vasconcelos Vieira Claudia Helena Ribeiro da Silva Renato Santiago Gomez |
| author_sort | Pedro Marcos Silva e Gonçalves |
| collection | DOAJ |
| description | Introduction and objectives: The use of neuromuscular blockers during surgery represented a landmark for anesthesiology. However, their use can prompt residual Neuromuscular Blockade (RNMB) and objective monitoring of neuromuscular function is crucial to warrant the recovery of muscle strength. The present study aimed to estimate the incidence of RNMB and late Neuromuscular Blockade (LNMB) at the Post-Anesthetic Recovery Unit (PACU). Method: The study included 85 patients, 43 of which received cisatracurium and 42 of which, rocuronium. The depth of the Neuromuscular Blockade (NMB) was assessed by Train Of Four (TOF). NMB reversal was performed with the administration of neostigmine and atropine.RNMB was defined when a patient presented TOF below 90% at the PACU. Results: RNMB at the PACU was diagnosed in 39.5% and 40.5% of the patients receiving cisatracurium and rocuronium, respectively (p = 1.0). LNMB at the PACU was found in 32.6% and 16.7% of the patients receiving cisatracurium and rocuronium, respectively (p = 0.131). Conclusions: The incidence ofRNMB remains significant despite the use of intermediate-acting neuromuscular blockers and reversal agents. There was no statistically significant difference in the incidence of RNMB or LNMB in patients receiving cisatracurium or rocuronium. The use of objective NMB monitoring is effective for the diagnosis of RNMB, as well as for treatment management. |
| first_indexed | 2024-04-12T09:44:26Z |
| format | Article |
| id | doaj.art-7624f29afc6f4662b252c8a00fa878ea |
| institution | Directory Open Access Journal |
| issn | 0104-0014 |
| language | English |
| last_indexed | 2024-04-12T09:44:26Z |
| publishDate | 2021-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brazilian Journal of Anesthesiology |
| spelling | doaj.art-7624f29afc6f4662b252c8a00fa878ea2022-12-22T03:38:00ZengElsevierBrazilian Journal of Anesthesiology0104-00142021-01-017113843Residual neuromuscular blockade and late neuromuscular blockade at the post-anesthetic recovery unit: prospective cohort studyPedro Marcos Silva e Gonçalves0Alexandra de Vasconcelos Vieira1Claudia Helena Ribeiro da Silva2Renato Santiago Gomez3Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Programa de Pós-Graduação em Ciências Aplicadas à Cirurgia e à Oftalmologia, Belo Horizonte, MG, Brasil; Corresponding author.Hospital Unimed BH – Unidade Contorno, Serviço de Anestesiologia, Belo Horizonte, MG, BrasilHospital Unimed BH – Unidade Contorno, Serviço de Anestesiologia, Belo Horizonte, MG, BrasilUniversidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Programa de Pós-Graduação em Ciências Aplicadas à Cirurgia e à Oftalmologia, Belo Horizonte, MG, BrasilIntroduction and objectives: The use of neuromuscular blockers during surgery represented a landmark for anesthesiology. However, their use can prompt residual Neuromuscular Blockade (RNMB) and objective monitoring of neuromuscular function is crucial to warrant the recovery of muscle strength. The present study aimed to estimate the incidence of RNMB and late Neuromuscular Blockade (LNMB) at the Post-Anesthetic Recovery Unit (PACU). Method: The study included 85 patients, 43 of which received cisatracurium and 42 of which, rocuronium. The depth of the Neuromuscular Blockade (NMB) was assessed by Train Of Four (TOF). NMB reversal was performed with the administration of neostigmine and atropine.RNMB was defined when a patient presented TOF below 90% at the PACU. Results: RNMB at the PACU was diagnosed in 39.5% and 40.5% of the patients receiving cisatracurium and rocuronium, respectively (p = 1.0). LNMB at the PACU was found in 32.6% and 16.7% of the patients receiving cisatracurium and rocuronium, respectively (p = 0.131). Conclusions: The incidence ofRNMB remains significant despite the use of intermediate-acting neuromuscular blockers and reversal agents. There was no statistically significant difference in the incidence of RNMB or LNMB in patients receiving cisatracurium or rocuronium. The use of objective NMB monitoring is effective for the diagnosis of RNMB, as well as for treatment management.http://www.sciencedirect.com/science/article/pii/S0104001420302116Neuromuscular blockersGeneral anesthesiaNeuromuscular monitoringNeostigmineRecovery unitPostoperative complications |
| spellingShingle | Pedro Marcos Silva e Gonçalves Alexandra de Vasconcelos Vieira Claudia Helena Ribeiro da Silva Renato Santiago Gomez Residual neuromuscular blockade and late neuromuscular blockade at the post-anesthetic recovery unit: prospective cohort study Brazilian Journal of Anesthesiology Neuromuscular blockers General anesthesia Neuromuscular monitoring Neostigmine Recovery unit Postoperative complications |
| title | Residual neuromuscular blockade and late neuromuscular blockade at the post-anesthetic recovery unit: prospective cohort study |
| title_full | Residual neuromuscular blockade and late neuromuscular blockade at the post-anesthetic recovery unit: prospective cohort study |
| title_fullStr | Residual neuromuscular blockade and late neuromuscular blockade at the post-anesthetic recovery unit: prospective cohort study |
| title_full_unstemmed | Residual neuromuscular blockade and late neuromuscular blockade at the post-anesthetic recovery unit: prospective cohort study |
| title_short | Residual neuromuscular blockade and late neuromuscular blockade at the post-anesthetic recovery unit: prospective cohort study |
| title_sort | residual neuromuscular blockade and late neuromuscular blockade at the post anesthetic recovery unit prospective cohort study |
| topic | Neuromuscular blockers General anesthesia Neuromuscular monitoring Neostigmine Recovery unit Postoperative complications |
| url | http://www.sciencedirect.com/science/article/pii/S0104001420302116 |
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