Residual curarization in the recovery room after vecuronium

Baillard, Christophe; Gehan, G.; Reboul‐Marty, Jeanne; Larmignat, P.; Samama, Charles Marc; Cupa, M

doi:10.1093/oxfordjournals.bja.a013445

Cited by 183 publications

(90 citation statements)

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“…Baillard et al [21] defined PORC as TOF falling below 70% after extubation and reported the incidence of PORC in the recovery room was 42%. In spite of the use of neostigmine to reverse the effects of muscle relaxant agents, development of PORC may be observed.…”

Section: Discussionmentioning

confidence: 99%

The effect of gender on reversal of non-depolarizing block with Sugammadex

Öztürk¹,

Pişkin²,

Küçükosman³

et al. 2017

Med-Science

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Sugammadex is a rapid and selective aminosteroid agent that has entered use recently. We aimed to research the effect of gender on reversal of non-depolarizing block with sugammadex. We designed a prospective study. The research included a total of 100 cases who underwent rhinoplasty operation administered general anaesthesia. Cases were divided according to gender as male (Group M) and female (Group F). At the end of the operation for patients with TOF value 25%, patients were given 2 mg kg-1 iv sugammadex. Duration from the rocuronium administration until the TOF value was zero(TOF0), the time from sugammadex administration until TOF reached from 25% to 90% was recorded (TOF25-90). The time from TOF90 to extubation was named the extubation duration. From the time the patients entered the PCU until Aldrete score was ≥9 was named the recovery duration and recorded. The time for the groups to TOF25-90 was 123.84 ± 38.03 s in Group M and 122.06 ± 30.461 s in Group F (p > 0.05). The extubation duration was 189.68 ± 41.37 s in Group M and 206.50 ± 45.99 in Group F (p = 0.316). The recovery time was 8.26 ± 14 min in Group M and 8.48 ± 14.23 min in Group F (p = 0.328). After the administration of sugammadex, there was no difference observed between the groups in terms of the TOF25-90 duration, recovery and extubation duration. As a result, conclusion was reached that gender did not affect rocuronium reversal with sugammadex.

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Section: Discussionmentioning

confidence: 99%

The effect of gender on reversal of non-depolarizing block with Sugammadex

Öztürk¹,

Pişkin²,

Küçükosman³

et al. 2017

Med-Science

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“…La incidencia de BNMR presenta una gran variabilidad con porcentajes que oscilan entre el 2% y el 64% 87,93,94,95,96,97,98,99,100,101,102,103,104,105 .…”

Section: Incidencia De Bnmrunclassified

Monitorización intraoperatoria del bloqueo neuromuscular y la presión arterial con un solo dispositivo (TOF-Cuff): estudio comparativo con la mecanomiografía y la presión arterial invasiva

Ruiz

Cayuela

Montes

et al. 2017

Revista Española de Anestesiología y Reanimación

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“…In a study examining neuromuscular block induced with vecuronium, Baillard et al [42] reported a higher median age in a group of patients with a detected PORC defined as TOFR < 0.7 compared to patients with greater TOFR values. This was confirmed by the results of two large prospective studies with residual blockade as the primary end-point in elderly patients after the administration of rocuronium [5,43].…”

Section: Residual Neuromuscular Block As a Significant Clinical Problmentioning

confidence: 99%

Blokada nerwowo-mięśniowa u osób w podeszłym wieku

Stankiewicz-Rudnicki

2016

Anaesthesiol Intensive Ther

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The aim of the presented review is to highlight the clinical problem of postoperative residual curarization (PORC) following general anaesthesia in the elderly. Possible complications of PORC are described along with age-induced changes in pharmacokinetics of long and intermediate-acting neuromuscular blocking agents. This is intended to facilitate the selection and to promote appropriate intraoperative use of muscle relaxants in patients over the age of 65 years.Key words: elderly patients; neuromuscular block, muscle relaxants; neuromuscular block, reversal; postoperative residual curarization Anaesthesiology Intensive Therapy 2016, vol. 48, no 4, 257-260 Anaesthesiologists are regularly involved in the treatment of elderly patients due to the increasing life expectancy and rising number of surgeries in the aging population [1]. General anaesthesia comprises four crucial components: unconsciousness, analgesia, immobilization and haemodynamic stability [2]. Neuromuscular block serves the two latter purposes. As it maintains good surgical conditions as well as facilitating airway management, doses of both volatile and intravenous anaesthetics can be considerably reduced. This is of importance in patients over 65 years of age, particularly those older than 75. This group of patients is most susceptible to the adverse effects of anaesthetics [3], including decreased heart muscle contractility and hypotension, which pose a risk of cardiac and central nervous system ischaemia [4].Unfortunately, advanced age is accompanied by an increasing risk of postoperative residual curarization (PORC) [5] which, along with intraoperative awareness [6], is one of the most clinically significant complications of the use of muscle relaxants. Residual blockade is currently defined by the train of four ratio (TOFR) < 0.9, although previous reports mentioned TOFR < 0.7. It may lead to severe respiratory complications in the post-operative period [7], and thus prolong hospitalization. Awareness of the specific issues of neuromuscular blocking agents use in the elderly is therefore crucial in daily anaesthesiological practice. CliniCal aspeCts of the pharmaCokinetiCs of neuromusCular bloCking agents in the elderlyDoses of both steroid and benzylisoquinoline-derived non-depolarising muscle relaxants necessary to reach maximal block, i.e. 95% reduction of muscle response to a stimulus (effective dose 95 , ED 95 ), do not vary significantly between elderly persons and younger subjects [8,9]. This suggests that the physiology of the neuromuscular junction and the pharmacodynamics of neuromuscular blocking agents are not markedly altered in advanced age. It is the pharmacokinetics of these agents that is responsible for their altered clinical effects in the elderly.Decreased cardiac output is accompanied by reduced skeletal muscle perfusion [3] and, consequently, one should expect a prolonged time to maximum blockade following drug administration [10,11]. However, doses of muscle relaxants used for intubation are two to three, or ...

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Residual curarization in the recovery room after vecuronium

Cited by 183 publications

References 0 publications

The effect of gender on reversal of non-depolarizing block with Sugammadex

The effect of gender on reversal of non-depolarizing block with Sugammadex

Monitorización intraoperatoria del bloqueo neuromuscular y la presión arterial con un solo dispositivo (TOF-Cuff): estudio comparativo con la mecanomiografía y la presión arterial invasiva

Blokada nerwowo-mięśniowa u osób w podeszłym wieku

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