Objective: To evaluate the occurrence and potential risk factors of residual curarisation after surgery and the subsequent acute respiratory events in elderly patients.
Methods: The prospective, cohort study was conducted at Ankara City Hospital from July to December 2021, and comprised data of geriatric patients undergoing elective surgery under general anaesthesia using moderate-acting nondepolarising muscle relaxants. Postoperative acute respiratory events in the post-anaesthesia care unit were subsequently noted. Data was analysed using SPSS 25.
Results: Of the 185 patients aged >65 years evaluated, 174(94%) were included; 88(50.6%) females and 86(49.4%) males. The incidence of residual curarisation was in 6(3.4%) patients. Postoperative residual curarisation was significantly associated with smooth recovery process (p<0.05). The recovery was associated with intraoperative bleeding, total dose of neuromuscular blocker, and the length of time from the last dose of neuromuscular blocker to antagonist administration (p<0.05). Postoperative critical respiratory events were more common in patients with postoperative residual curarisation (p< 0.001). The length of stay in post-anaesthesia care unit was 1.57 times longer in such patients (p=0.001).
Conclusion: Postoperative residual curarisation increased length of hospital stay and respiratory complications.
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Postoperative residual curarisation in geriatric patients: a prospective, observational cohort study.
J Pak Med Assoc
April 2024
Department of Anaesthesiology and Reanimation, Ankara City Hospital, Ankara, Turkey.
Objective: To evaluate the occurrence and potential risk factors of residual curarisation after surgery and the subsequent acute respiratory events in elderly patients.
Methods: The prospective, cohort study was conducted at Ankara City Hospital from July to December 2021, and comprised data of geriatric patients undergoing elective surgery under general anaesthesia using moderate-acting nondepolarising muscle relaxants. Postoperative acute respiratory events in the post-anaesthesia care unit were subsequently noted.
Under-dosing and over-dosing of neuromuscular blocking drugs and reversal agents: beware of the risks.
Br J Anaesth
March 2024
Department of Anaesthesiology and Intensive Care Medicine, School of Medicine and Health, Technical University of Munich, Munich, Germany; Department of Anaesthesiology and Intensive Care Medicine, Faculty of Medicine, University of Ulm, Ulm, Germany.
The phenomena of residual curarisation and recurarisation after the use of long-acting non-depolarising neuromuscular blocking drugs such as tubocurarine and pancuronium were well recognised 60 years ago. But the incidence seemed to decline with the introduction of atracurium and vecuronium. However, recently there have been an increasing number of reports of residual and recurrent neuromuscular block.
View Article and Find Full Text PDFAn educational intervention to reduce the incidence of postoperative residual curarisation: a cluster randomised crossover trial in patients undergoing general anaesthesia.
Br J Anaesth
September 2023
Department of Anaesthesiology, Hospital Universitario y Politécnico la Fe, Valencia, Spain; Perioperative Medicine Research Group, Hospital Universitario y Politécnico la Fe, Valencia, Spain.
Background: The incidence of postoperative residual curarisation remains unacceptably high. We assessed whether an educational intervention on perioperative neuromuscular block management can reduce it.
Methods: In this multicentre, cluster randomised crossover trial, centres were allocated to receive an educational intervention either in a first or a second period.
[Advances of Diaphragm Ultrasound in Anesthesia Management].
Zhongguo Yi Xue Ke Xue Yuan Xue Bao
October 2022
Department of Anesthesiology, PUMC Hospital,CAMS and PUMC,Beijing 100730,China.
Article Synopsis
- - Diaphragm ultrasound evaluates diaphragm performance using three key indicators: excursion, thickness, and thickening fraction, and is commonly used in anesthesia management.
- - It aids in diagnosing postoperative issues like residual curarisation and identifying patients at risk for pulmonary complications after surgery.
- - The technique is also valuable for assessing patients with respiratory conditions and guiding extubation and weaning from mechanical ventilation in intensive care settings.
[Evaluation of Postoperative Residual Curarisation after Administration of Neostigmine or Sugammadex by Diaphragmatic Ultrasonography:A Randomized Double-blind Controlled Trial].
Zhongguo Yi Xue Ke Xue Yuan Xue Bao
June 2022
Department of Anesthesiology, PUMC Hospital,CAMS and PUMC,Beijing 100730,China.
Objective To evaluate and compare the incidence of postoperative residual curarisation (PORC) after administration of neostigmine or sugammadex by diaphragmatic ultrasonography.Methods A total of 100 patients with American Society of Anesthesiologists grade Ⅰ or Ⅱ who underwent elective joint replacement surgery from March to August in 2021 were randomly enrolled into the neostigmine+atropine group(N+A group,=51) and sugammadex group(SUG group,=49) according to a random number table.Muscle relaxation was monitored by train of four(TOF) stimulation of adductor pollicis muscle during anesthesia.
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