Residual neuromuscular block in paediatric anaesthesia

J 2019

Residual neuromuscular block in paediatric anaesthesia

KLUČKA, Jozef, Martina KOSINOVÁ, Ivo KŘIKAVA, Roman ŠTOUDEK, Michaela ŤOUKÁLKOVÁ et. al.

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

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30223 Anaesthesiology

Country of publisher

United Kingdom of Great Britain and Northern Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

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

Abstract

ORIG CZ

V originále

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.

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

Citovat

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.

@article{1489907,
   author = {Klučka, Jozef and Kosinová, Martina and Křikava, Ivo and Štoudek, Roman and Ťoukálková, Michaela and Štourač, Petr},
   article_location = {OXFORD},
   article_number = {1},
   doi = {http://dx.doi.org/10.1016/j.bja.2018.10.001},
   keywords = {neuromuscular blockade; paediatric anaesthesia; residual blockade},
   language = {eng},
   issn = {0007-0912},
   journal = {British Journal of Anaesthesia},
   title = {Residual neuromuscular block in paediatric anaesthesia},
   url = {http://dx.doi.org/10.1016/j.bja.2018.10.001},
   volume = {122},
   year = {2019}
}

TY  - JOUR
ID  - 1489907
AU  - Klučka, Jozef - Kosinová, Martina - Křikava, Ivo - Štoudek, Roman - Ťoukálková, Michaela - Štourač, Petr
PY  - 2019
TI  - Residual neuromuscular block in paediatric anaesthesia
JF  - British Journal of Anaesthesia
VL  - 122
IS  - 1
SP  - "E1"-"E2"
EP  - "E1"-"E2"
PB  - Oxford University Press
SN  - 00070912
KW  - neuromuscular blockade
KW  - paediatric anaesthesia
KW  - residual blockade
UR  - http://dx.doi.org/10.1016/j.bja.2018.10.001
L2  - http://dx.doi.org/10.1016/j.bja.2018.10.001
N2  - 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.
ER  -

KLUČKA, Jozef, Martina KOSINOVÁ, Ivo KŘIKAVA, Roman ŠTOUDEK, Michaela ŤOUKÁLKOVÁ and Petr ŠTOURAČ. Residual neuromuscular block in paediatric anaesthesia. \textit{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.

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