The influence of residual neuromuscular block on the incidence of critical respiratory events. A randomised, prospective, placebo-controlled trial

Sauer, Martin; Stahn, Alexander; Soltész, Stefan; Noeldge-Schomburg, Gabriele; Mencke, Thomas

doi:10.1097/eja.0b013e328345cd11

Cited by 78 publications

(52 citation statements)

References 40 publications

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“…10,14,15 The diaphragm recovers more quickly from the effect of muscle relaxants than the pharynx. Residual pharyngeal muscle paralysis causes the base of the tongue and the posterior oropharyngeal tissues to bunch together, producing supraglottal obstruction.…”

Section: Introductionmentioning

confidence: 98%

Adverse Respiratory Events in a Post-Anesthesia Care Unit

Xará

Santos

Abelha

2015

Archivos de Bronconeumología (English Edition)

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Section: Introductionmentioning

confidence: 98%

Adverse Respiratory Events in a Post-Anesthesia Care Unit

Xará

Santos

Abelha

2015

Archivos de Bronconeumología (English Edition)

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“…It is a very potent drug and if incorrectly used, it increases morbidity in surgical patients 22,23 . One can only speculate that its high popularity is further enhanced by the introduction of sugammadex into clinical practice.…”

Section: Yrs Influence Of Age and Gender On The Pharmacodynamic Parammentioning

confidence: 99%

Influence of Age and Gender on the Pharmacodynamic Parameters of Rocuronium During Total Intravenous Anesthesia

Adamus

Hrabálek²,

Wanek³

et al. 2011

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Aims.To compare the pharmacodynamics of 0.6 mg kg -1 rocuronium in young and older patients of both genders during total intravenous anesthesia.Methods. Following local ethics committee approval and informed consent, patients scheduled for surgery under total intravenous anesthesia (propofol/sufentanil) were divided into 4 study groups: 37 males aged 20-40, 40 males aged 60-75 yrs, 43 females aged 20-40 and 38 females aged 60-75 yrs. Neuromuscular block following rocuronium (0.6 mg kg -1 ) was monitored: train-of-four [TOF] stimulation of the ulnar nerve at 15-s intervals, EMG of the adductor pollicis muscle. The onset time (from application of rocuronium to maximum depression of T 1 ), clinical duration (from application to 25% recovery of T 1 ), and time to full spontaneous recovery (from application to TOF-ratio ≥ 0.9) were determined for each patient. The Kruskal-Wallis test was used to compare differences between groups; P<0.05 was considered statistically significant.Results.

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“…Some of these critical respiratory events are attributable to incomplete reversal of the effect of muscle relaxants [3], since residual relaxation may cause clinically relevant signs and symptoms of muscle weakness. Murphy [5], Plaud [2] and Sauer [6] have demonstrated that even minimal residual block was associated with hypoxaemia in the PACU.…”

Section: Introductionmentioning

confidence: 99%

Residual curarization and postoperative respiratory complications following laparoscopic sleeve gastrectomy. The effect of reversal agents: sugammadex vs. neostigmine

Ezri

Evron

Petrov

et al. 2015

The Journal of Critical Care Medicine

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Background: Incomplete muscle relaxant reversal or re-curarization may be associated with postoperative respiratory complications. In this retrospective study we compared the incidence of postoperative residual curarization and respiratory complications in association with the type of muscle relaxant reversal agent, sugammadex or neostigmine, in patients undergoing laparoscopic sleeve gastrectomy. Material and methods:We reviewed the charts of all patients (179) undergoing laparoscopic sleeve gastrectomy from July 2012 to July 2013 at Wolfson Medical Center. Sugammadex 1.5-2 mg/kg (112 patients) or neostigmine 2.5 mg (67 patients) were used as reversal agents. Results were compared by the type of reversal agent employed. Compared parameters included demographic and anaesthetic data, residual curarization, oxyhemoglobin saturation (SpO 2 ) in the recovery room (PACU), episodes of SpO 2 lower than 90% in PACU, unexpected intensive care (ICU) admissions, incidence of atelectasis and pneumonia, re-intubation and duration of hospitalization. Results: Obstructive sleep apnea syndrome (OSAS) was more frequent in the sugammadex group (19% vs. 8%; p = 0.026). Total intravenous anesthesia (TIVA) was more frequently associated with sugammadex (33% vs. 16%; p = 0.007). There were no differences in postoperative residual curarization, SpO 2 < 90% episodes, reintubation, ICU admissions, pulmonary complications and duration of hospitalization. Conclusion: With the inherent limitations of a retrospective study, the use of sugammadex following laparoscopic sleeve gastrectomy showed no advantage over neostigmine in terms of residual curarization and respiratory complications.

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The influence of residual neuromuscular block on the incidence of critical respiratory events. A randomised, prospective, placebo-controlled trial

Abstract: In this randomised, prospective, placebo-controlled trial, minimal residual block was associated with hypoxaemia in the post-anaesthesia care unit. Neostigmine 20 μg kg was effective in antagonising rocuronium-induced (minimal) blockade.

Cited by 78 publications

References 40 publications

Adverse Respiratory Events in a Post-Anesthesia Care Unit

Adverse Respiratory Events in a Post-Anesthesia Care Unit

Influence of Age and Gender on the Pharmacodynamic Parameters of Rocuronium During Total Intravenous Anesthesia

Residual curarization and postoperative respiratory complications following laparoscopic sleeve gastrectomy. The effect of reversal agents: sugammadex vs. neostigmine

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