Residual neuromuscular block in paediatric anaesthesia

KLUČKA, Jozef, Martina KOSINOVÁ, Ivo KŘIKAVA, Roman ŠTOUDEK, Michaela ŤOUKÁLKOVÁ and Petr ŠTOURAČ. Residual neuromuscular block in paediatric anaesthesia. British Journal of Anaesthesia. OXFORD: Oxford University Press, 2019, vol. 122, No 1, p. "E1"-"E2", 2 pp. ISSN 0007-0912. Available from: https://dx.doi.org/10.1016/j.bja.2018.10.001.

Basic information

• Original name: Residual neuromuscular block in paediatric anaesthesia
• Name in Czech: Reziduální nervosvalová blokáda v dětské anestezii
• Authors: KLUČKA, Jozef (703 Slovakia, belonging to the institution), Martina KOSINOVÁ (203 Czech Republic, belonging to the institution), Ivo KŘIKAVA (203 Czech Republic, belonging to the institution), Roman ŠTOUDEK (203 Czech Republic, belonging to the institution), Michaela ŤOUKÁLKOVÁ (203 Czech Republic, belonging to the institution) and Petr ŠTOURAČ (203 Czech Republic, guarantor, belonging to the institution).
• Edition: British Journal of Anaesthesia, OXFORD, Oxford University Press, 2019, 0007-0912.

Other information

• Original language: English
• Type of outcome: Article in a journal
• Field of Study: 30223 Anaesthesiology
• Country of publisher: United Kingdom of Great Britain and Northern Ireland
• Confidentiality degree: is not subject to a state or trade secret
• WWW: URL
• Impact factor: Impact factor: 6.880
• RIV identification code: RIV/00216224:14110/19:00109048
• Organization unit: Faculty of Medicine
• Doi: http://dx.doi.org/10.1016/j.bja.2018.10.001
• UT WoS: 000453927600001
• Keywords (in Czech): nervosvalová blokáda; dětská anestezie; reziduální blokáda
• Keywords in English: neuromuscular blockade; paediatric anaesthesia; residual blockade
• Tags: 14110322, rivok
• Tags: International impact, Reviewed

Abstract

Background: Residual neuromuscular blockade (RNB) in postoperative period is frequent (26-88%) and it is associated with negative impact on perioperative morbidity. The safety cut-off measured by accelerometry is currently defined as Train-of-four ratio (TOFr) >= 0.9. The primary outcome of the study was detect the incidence of RNB measured just prior extubation in the operating room (OR) (according to pragmatic trial design) and the secondary outcome was the incidence of the RNB in postanaethesia care unit (PACU). Methods: After Ethics Committee (10/2016) approval, paediatric patients (1.1.2017-31.12.2017) undergoing surgery in general anaesthesia with muscle relaxation were included in the study. The level of blockade was measured just prior to extubation in OR (patient eligible for extubation according to the anesthesiologist) and after arrival at PACU with acceleromtery – TOF-Watch®SX (Organon, Inc, West Orange, NJ). The mode for measurement was Train-of-four (TOF) and Train-of-four ratio (TOFr), in case of deep blockade Post-tetanic count (PTC). Data are described by descriptive analytic methods (mean, standard deviation -SD, median). Results: Overall, 291 patients were included in the study. The incidence of RNB in the OR was 48.2 % (95% CI: 42.4 54.1%, n=136) and the incidence of RNB in PACU was 26.9 % (95% CI: 19.5 35.3 %, n = 32). Active block reversal was administered in 23.3% (n=68) patients. Overall, 31.6% (87/275) patients were extubated with TOFr<0.9. Conclusion: Residual neuromuscular blockade in selected cohort of paediatric patients was frequent.

Abstract (in Czech)

Práce popisuje incidenci reziduální nervosvalové blokády na operačním sále a na dospávacím pokoji u dětských pacientů.

Links

• MUNI/A/1111/2018, interní kód MU: Name: Videolaryngoskopie vs. přímá laryngoskopie vliv na efektivitu intubace: randomizovaná kontrolovaná studie (Acronym: VidoeLarynx)

Investor: Masaryk University, Category A