Prevalence and Risk Factors of Postoperative Residual Curarization in Patients Arriving at Postanesthesia Care Unit after General Anesthesia: A Prospective Cohort Study

Unrecognised postoperative residual curarisation in developing countries remains a common problem

“…The administration of an anticholinesterase to antagonise the effects of the neuromuscular blocking agent has previously been found to be necessary to reduce the incidence of PORC. [7,28] In our study, although the use of a reversal agent was not significantly associated with TOFR status, it is worth noting that, of the 7 participants who did not receive neostigmine, 6 had a TOFR ≤0.9. As the number of participants who did not receive a reversal agent is small, it is possible that for a larger sample size, application of an anticholinesterase would show significant association with TOFR status.…”

“…[1] The use of longacting NDMRs is known to increase the likelihood of PORC, [2][3][4] but intermediate-acting NDMR use has also been associated with substantial risk of residual paralysis. [5][6][7] Residual effects of neuromuscular blocking agents delay discharge of patients from the operating theatre recovery room and place them at risk of developing a number of clinical complications postoperatively. Clinical consequences of PORC include an increased risk of respiratory complications, prolonged intubation times and increased patient morbidity.…”

“…[8] General factors that increase the risk of PORC include the use of high doses of NDMRs, hypothermia, and premature or delayed administration of anticholinesterase reversal agents. [6][7] NDMRs should therefore be used with caution in patients who are elderly [9] or obese, [10] have sleep apnoea [11] and who have neuromuscular or respiratory pathology, [12] owing to the risks associated with these drugs.…”