Objective:To observe the incidence of residual neuromuscular blockade at the end of operation and during tracheal extubation, and analyze the risk factors causing residual neuromuscular blockade by judging the degree ...Objective:To observe the incidence of residual neuromuscular blockade at the end of operation and during tracheal extubation, and analyze the risk factors causing residual neuromuscular blockade by judging the degree of muscle relaxation according to clinical signs when after using rocuronium or cis-atracurium in general anesthesia.Methods: 500 adults were implemented with propofol-remifentanil intravenous anesthesia or sevoflurane inhalation anesthesia. Rocuronium and cis-atracurium were given, respectively. The TOFr was observed with blind method by TOF Watch SX monitor during anesthesia.Results: The mean TOFr=0.53±0.38 at the end of operation,including 275 cases of 0<TOFr<0.9 and 112 cases of TOFr=0. The mean TOFr=0.97±0.12 at extubation, including 60 cases of TOFr<0.9. The incidence of residual neuromuscular blockade at extubation showed an increasing trend with the increase of age or body mass index. The average TOFr value at extubation, which interval time over 10 min after neostigmine administration to extubation was significant higher than that of interval time less than 10 min.Conclusions:There has 12% patients with TOFr<0.9 when extubation by estimating rocuronium and cis-atracurium effect with clinical signs and experience, it has a hidden danger of residual neuromuscular blockade. The main risk factors to increasing the incidence of residual neuromuscular blockade are growing old and the short time of administrating muscle relaxants or neostigmine to extubation.展开更多
基金Guangdong science and technology plan project (2013B31800248).
文摘Objective:To observe the incidence of residual neuromuscular blockade at the end of operation and during tracheal extubation, and analyze the risk factors causing residual neuromuscular blockade by judging the degree of muscle relaxation according to clinical signs when after using rocuronium or cis-atracurium in general anesthesia.Methods: 500 adults were implemented with propofol-remifentanil intravenous anesthesia or sevoflurane inhalation anesthesia. Rocuronium and cis-atracurium were given, respectively. The TOFr was observed with blind method by TOF Watch SX monitor during anesthesia.Results: The mean TOFr=0.53±0.38 at the end of operation,including 275 cases of 0<TOFr<0.9 and 112 cases of TOFr=0. The mean TOFr=0.97±0.12 at extubation, including 60 cases of TOFr<0.9. The incidence of residual neuromuscular blockade at extubation showed an increasing trend with the increase of age or body mass index. The average TOFr value at extubation, which interval time over 10 min after neostigmine administration to extubation was significant higher than that of interval time less than 10 min.Conclusions:There has 12% patients with TOFr<0.9 when extubation by estimating rocuronium and cis-atracurium effect with clinical signs and experience, it has a hidden danger of residual neuromuscular blockade. The main risk factors to increasing the incidence of residual neuromuscular blockade are growing old and the short time of administrating muscle relaxants or neostigmine to extubation.
