Journals / Anestezi Dergisi / 2011 / Cilt: 19 - Sayı: 2

Postoperative residual block and complications

Postoperatif rezidüel blok ve komplikasyonları

Pages
73–78
DOI
—
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Not only to rapidly reverse the effects of muscle relaxants, but also to manage PORB at the end of the surgical procedure, agents that reverse the effects of muscle relaxants like asetilcholine esterase inhibitors or sugammadex are being used.

📌 3 Key Takeaways

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Objective & Hypothesis:In general anesthesia practice the neuromuscular blockers are being widely used for endotracheal intubation and intraoperative muscle relaxation.
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Key Findings & Data:For the protection of the airway a TOF value of >0.9 is necessary.
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Conclusion & Impact:Not only to rapidly reverse the effects of muscle relaxants, but also to manage PORB at the end of the surgical procedure, agents that reverse the effects of muscle relaxants like asetilcholine esterase inhibitors or sugammadex are being used.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

In general anesthesia practice the neuromuscular blockers are being widely used for endotracheal intubation and intraoperative muscle relaxation. However, it should not be neglected that they might also have severe side effects. One of those side effects is postoperative residual block (PORB) which is a state of postoperative paralysis when these agents are used. This could cause serious complications like aspiration of gastric content, airway obstruction and respiratory depression. In order to prevent PORB, objective and quantitative neuromuscular junction monitorisation before extubation is required. For the protection of the airway a TOF value of >0.9 is necessary. Not only to rapidly reverse the effects of muscle relaxants, but also to manage PORB at the end of the surgical procedure, agents that reverse the effects of muscle relaxants like asetilcholine esterase inhibitors or sugammadex are being used.

Özet

Kas gevşeticiler genel anestezi pratiğinde endotrakeal entübasyon ve intraoperatif kas gevşemesi amacıyla sıkça kullanılmaktadırlar. Ancak ciddi yan etkilerinin olabileceği göz ardı edilmemelidir. Kas gevşetici kullanımını takiben gelişen postoperatif felç hali olarak tanımlanan postoperatif rezidüel blok (PORB) bu yan etkilerden biri olarak tanımlanmaktadır. Bu durum mide içeriğinin aspirasyonu, havayolu tıkanıklığı ve solunumun baskılanması gibi ciddi komplikasyonlara neden olabilir. PORB'u önlemek için ekstübasyon öncesi objektif ve kantitatif nöromüsküler sinir kas kavşağı monitörizasyonları gerekmektedir. Havayolunun korunması için 0,9'dan büyük TOF değeri gereklidir. Kas gevşeticiler in etkilerini hızla geri döndürmek için olduğu kadar, ayrıca cerrahi girişimin bitiminde PORB'un idamesi amacıyla da asetilkolin esteraz veya sugammadex gibi kas gevşeticilerin etkilerini geri dönüştüren ajanlar kullanılmaktadır.

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Cite This Article

ALKIŞ, N., MEÇO, B. C. (2011). Postoperative residual block and complications. Anestezi Dergisi, Cilt: 19 - Sayı: 2, 73–78. https://ajindex.com/articles/195930

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References (16)

  1. Claudius C, Garvey LH, Viby-Mogensen J. The undesirable effects of neuromuscular blocking drugs. Anaesthesia 2009
  2. 64(Suppl 1): 10-21. 2.Tsai CC, Chung HS, Chen PL, Yu CM, Chen MS, Hong CL. Postoperative residual curarization: clinical observation in the post-anesthesia care unit. Chang Gung Med J 2008
  3. Srivastava A, Hunter JM. Reversal of neuromuscular block. Br J Anaesth 2009
  4. 103( 1): 115-129. 4.Shabana Khan S, Divatia JV, Sareen R. Comparison of residual neuromuscular blockade between two intermediare acting nondepolarizing neuromuscular blocking agents-rocuronium and vecuronium. Indian J Anaesth 2006
  5. 50(2):115-117. 5.Bevan DR. Monitoring and reversal of neuromuscular block. Am J Health Syst Pharm 1999
  6. 56(Suppl 11):10-13. 6.Johansen SH, Jorgensen M, Molbech S. Effect of tubocurarine on respiratory and nonrespiratory muscle power in man. J Appl Physiol 1964
  7. Ali HH, Savarese JJ. Monitoring of neuromuscular function. Anesthesiology 1976
  8. 45(2):216-249. 8.Beemer GH, Rozental P. Postoperative neuromuscular function. Anaesth Intensive Care 1986
  9. 14(l):41-45. 9.Debaene B, Plaud B, Dilly MP, Donati F. Residual paralysis in the PACU after a single intubating dose of nondepolarizing muscle relaxant with an intermediate duration of action. Anesthesiology 2003
  10. 98(5): 1042-1048. 10.Kopman AF, Zank LM, Ng J, Neuman GG. Antagonism of cisatracurium and rocuronium block at a tactile train-of- four count of 2: should quantitative assessment of neuromuscular function be mandatory? Anesth Analg 2004
  11. 98(1): 102-106. 11.Andersen BN, Madsen JY, Schurizek BA, Juhl B. Residual curarisation: a comparative study of atracurium and pancuronium. Acta Anaesthesiol Scand 1988
  12. 32(2):79-81. 12.Bevan DR, Smith CE, Donati F. Postoperative neuromuscular blockade: a comparison between atracurium, vecuronium, and pancuronium. Anesthesiology 1988
  13. 69(2):272-276. 13.Howardy-Hansen P, Rasmunsen JA, Jensen BN. Residual curarisation in the recovery room: atracurium versus gallamine. Acta Anaesthesiol Scand 1989
  14. 33(2): 167-169. 14.American Society of Anesthesiologists Task Force on Postanesthetic Care. Practice guidelines for postanesthetic care: a report by the American Society of Anesthesiologists Task Force on Postanesthetic Care. Anesthesiology 2002
  15. 96(3):742-752. 15.Ali HH, Utting JE, Gray TC. Quantitative assessment of residual antidepolarizing block. II. Br J Anaesth 1971
  16. 43(5):478-485. 16.Bissinger U, Schimek F, Lenz G. Postoperative residual paralysis and respir