| ||||||||||||||
|
|
|||||||||||||
Department of Anesthesiology, Hanyang University Hospital, Seoul, Korea
Address correspondence and reprint requests to Kyo Sang Kim, MD, PhD, Department of Anesthesiology, Hanyang University Hospital, #17 Haengdang dong, Sungdong gu, Seoul 133792, Korea. Address e-mail to kimks{at}hanyang.ac.kr
We investigated postoperative residual curarization after administration of either vecuronium or rocuronium with reversal by pyridostigmine in 602 consecutive patients without perioperative neuromuscular monitoring. On arrival in the recovery room, neuromuscular function was assessed both by acceleromyography in a train-of-four (TOF) pattern and also clinically by the ability to sustain a head-lift for >5 s and the tongue-depressor test. Postoperative residual curarization was defined as a TOF ratio <0.7. One fifth of 602 patients (vecuronium, 24.7%; rocuronium, 14.7%) had a TOF <0.7 in the recovery room. There were no significant differences in the TOF ratios between 10 mg and 20 mg of pyridostigmine. The patients with residual block had several associated factors: the absence of perioperative neuromuscular monitoring, the use of pyridostigmine, which is less potent than neostigmine, a larger dose of vecuronium, shorter time from the last neuromuscular blocker to TOF monitoring, or peripheral cooling. We conclude that significant residual neuromuscular block after vecuronium or rocuronium was not eliminated even with reversal by a large dose of pyridostigmine.
IMPLICATIONS: Without monitoring, the significant residual neuromuscular block after vecuronium or rocuronium is not eliminated even by reversal with a large dose of pyridostigmine and can still be a problem in the recovery room.
This article has been cited by other articles:
![]() |
M. Naguib, A. F. Kopman, and J. E. Ensor Neuromuscular monitoring and postoperative residual curarisation: a meta-analysis Br. J. Anaesth., March 1, 2007; 98(3): 302 - 316. [Abstract] [Full Text] [PDF] |
||||
![]() |
O. Sacan, P. F. White, B. Tufanogullari, and K. Klein Sugammadex Reversal of Rocuronium-Induced Neuromuscular Blockade: A Comparison with Neostigmine-Glycopyrrolate and Edrophonium-Atropine Anesth. Analg., March 1, 2007; 104(3): 569 - 574. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. Naguib Sugammadex: Another Milestone in Clinical Neuromuscular Pharmacology Anesth. Analg., March 1, 2007; 104(3): 575 - 581. [Abstract] [Full Text] [PDF] |
||||
![]() |
G. S. Murphy, J. W. Szokol, J. H. Marymont, M. Franklin, M. J. Avram, and J. S. Vender Residual Paralysis at the Time of Tracheal Extubation Anesth. Analg., June 1, 2005; 100(6): 1840 - 1845. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. F. Kopman, L. M. Zank, J. Ng, and G. G. Neuman 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., January 1, 2004; 98(1): 102 - 106. [Abstract] [Full Text] [PDF] |
||||
|