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Incidence of postoperative residual neuromuscular blockade in the postanaesthesia care unit: an observational multicentre study in Portugal.

dc.contributor.authorEsteves, S
dc.contributor.authorMartins, M
dc.contributor.authorBarros, F
dc.contributor.authorBarros, F
dc.contributor.authorCanas, M
dc.contributor.authorVitor, P
dc.contributor.authorSeabra, M
dc.contributor.authorCastro, M
dc.contributor.authorBastardo, I
dc.date.accessioned2015-08-25T14:28:53Z
dc.date.available2015-08-25T14:28:53Z
dc.date.issued2013
dc.description.abstractCONTEXT: Residual neuromuscular blockade still presents despite the use of intermediate duration muscle relaxants and is a risk factor for postoperative morbidity. OBJECTIVE: To determine the incidence of incomplete postoperative neuromuscular recovery from anaesthesia in a postanaesthesia care unit. DESIGN: Multicentre observational study. SETTING: Public Portuguese hospitals. PATIENTS: Adult patients scheduled for elective surgery requiring general anaesthesia with neuromuscular blocking agents. MAIN OUTCOME MEASURES: An independent anaesthesiologist measured neuromuscular transmission by the TOF-Watch SX acceleromyograph. Train-of-four ratios at least 0.9 and less than 0.9 were assessed as complete and incomplete neuromuscular recovery following general anaesthesia, respectively. RESULTS: The study population consisted of 350 patients [134 men and 216 women, mean (SD) age 54.3 (15.9) years]. Ninety-one patients had a train-of-four ratio less than 0.9 on arrival in the postanaesthesia care unit, an incidence of residual neuromuscular blockade of 26% [95% confidence interval (CI) 21 to 31%]. The most frequent neuromuscular blockers were rocuronium (44.2%) and cisatracurium (32%). A neuromuscular block reversal agent was used in 66.6% of the patients (neostigmine in 97%). The incidence of residual neuromuscular blockade in patients receiving reversal agents was 30% (95% CI 25 to 37%). There were no statistically significant differences in the occurrence of residual blockade relating to the neuromuscular blocker used, although higher percentages were observed for cisatracurium (32.4%) and vecuronium (32%) compared with atracurium (23.6%) and rocuronium (20.8%). Incomplete neuromuscular recovery was significantly more frequent among patients who had received a reversal agent (30.5 vs. 17.1%, P = 0.01). Incomplete neuromuscular recovery was more frequent in patients given propofol than in those exposed to sevoflurane (26.2 vs. 14.3%). CONCLUSION: The incidence of incomplete neuromuscular recovery of 26% confirms that it is relatively frequent in the postoperative period and calls attention to the dimension of this problem in Portugalpor
dc.identifier.citationEur J Anaesthesiol. 2013 May;30(5):243-9por
dc.identifier.doi10.1097/EJA.0b013e32835dccd7
dc.identifier.urihttp://hdl.handle.net/10400.10/1517
dc.language.isoengpor
dc.peerreviewedyespor
dc.publisherEuropean Academy of Anaesthesiologypor
dc.subjectNeuromuscular blockadepor
dc.subjectAnesthesia recovery periodpor
dc.subjectIncidencepor
dc.subjectPortugalpor
dc.titleIncidence of postoperative residual neuromuscular blockade in the postanaesthesia care unit: an observational multicentre study in Portugal.por
dc.typejournal article
dspace.entity.typePublication
oaire.citation.conferencePlaceOxfordpor
oaire.citation.endPage249por
oaire.citation.startPage243por
oaire.citation.titleEuropean journal of anaesthesiologypor
oaire.citation.volume30por
rcaap.rightsclosedAccesspor
rcaap.typearticlepor

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