Philippine E-Journals

Incidence of Residual Neuromuscular Blockade with the Use of Intermediate Acting Non-Depolarizing Neuromuscular Blockers at Manila Central University - Filemon D. Tanchoco Medical Foundation Hospital Post Anesthesia Care Unit

Mark Joseph R. De Guzman | Ma. Lilybeth R. Tanchoco

 

Abstract:

Background: Residual neuromuscular blockade is common in the post-anesthesia care unit (PACU), and if left undetected may predispose to postoperative complications. Locally, there is no locally published data on incidence of residual neuromuscular blockade in the PACU. Objective: The goal of this study is to determine local incidence of residual neuromuscular blockade with the use of intermediate acting non-depolarizing neuromuscular blocking drugs (NMBD) at the PACU. Methods: This is a prospective, open-labeled, observational study involving subjects who underwent elective surgery under general anesthesia with the use of intermediate acting non-depolarizing NMBD. Subjects aged 19-65, classified as ASA I-III who were transferred to the PACU. Upon the subjects’ arrival at the PACU, train-of-four (TOF) watch was applied and TOF ratio was measured. Age, gender, surgical procedure, NMBD used, use of reversal agents, and TOF ratio were recorded. Results: There were 243 subjects whose TOF ratio were measured. Of these, 230 were eligible while 13 were given a reversal agent, neostigmine. Out of the 230 subjects, 151 (65.7%) had residual neuromuscular block while only 79 (34.3%) had a TOF ratio of more than 0.9. Based on logistic regression analysis, the only risk factor affecting residual neuromuscular block was gender and was increased in women (OR: 1.82, 95%, CI: 1.00–3.29). Conclusion: This study demonstrated that residual neuromuscular blockade was common in our institution’s PACU. It was more common in female than male patients. Age and the use of reversal agent were not factors in manifesting residual neuromuscular blockade.