Neuromuscular blockade. Inadvertent extubation of the partially paralyzed patient.
Residual neuromuscular block is common after the use of neuromuscular blocking drugs during anesthesia. Although careful reversal [table: see text] techniques usually result in adequate return of neuromuscular recovery, sometimes it is not possible to achieve full recovery of neuromuscular block. Ventilatory support and maintenance of a patent airway are required until recovery can be demonstrated. In those situations, in which some TOF fade is still obvious, the anesthesiologist should consider retaining the endotracheal tube in position; it is not a sign of failure to return a patient whose trachea is still intubated to the postanesthesia care unit. The inadvertent extubation of patients who are partially paralyzed results in increased postoperative morbidity.
Bevan
D R
DR
Department of Anesthesia, University of Toronto, University Health Network, Toronto General Hospital, Toronto, Ontario, Canada. david.bevan@utoronto.ca
D000758:Anesthesia / Q000009:adverse effects*; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D019148:Neuromuscular Blockade; D010291:Paresis / Q000150:complications*; D011184:Postoperative Period