Postoperative residual paralysis in outpatients versus inpatients.
Postoperative residual paralysis is an important complication of the use of neuromuscular blocking drugs. In this prospective study, the incidence of residual paralysis detected as a train-of-four response <90% was less frequent in surgical outpatients (38%) than inpatients (47%) (P = 0.001). This might have been the result of the more frequent use of mivacurium for outpatients. Before undertaking tracheal extubation, the anesthesiologists had applied clinical criteria (outpatients, 49%; inpatients, 45%), pharmacological reversal (26%, 25%), neuromuscular transmission monitoring (12%, 11%), or a combination of these. None of these measures seemed to reduce the incidence of residual paralysis except for quantitative train-of-four monitoring. Postoperatively, eight individual clinical tests or a sum of these tests were also unable to predict residual paralysis by train-of-four. Although the incidence of residual paralysis was less frequent in surgical outpatients, predictive criteria were not evident.
Cammu
Guy
G
Department of Anesthesiology and Critical Care Medicine, OLV Clinic, Aalst, Belgium. guy.cammu@olvz-aalst.be
De Witte
Jan
J
De Veylder
Jan
J
Byttebier
Geert
G
Vandeput
Dirk
D
Foubert
Luc
L
Vandenbroucke
Geert
G
Deloof
Thierry
T
D000328:Adult; D000556:Ambulatory Surgical Procedures; D000762:Anesthesia Recovery Period; D006760:Hospitalization; D006801:Humans; D007297:Inpatients; D007442:Intubation, Intratracheal; D016343:Monitoring, Intraoperative; D009460:Neurologic Examination; D019148:Neuromuscular Blockade; D009466:Neuromuscular Blocking Agents / Q000008:administration & dosage*; D010243:Paralysis / Q000188:drug therapy / Q000209:etiology*; D011183:Postoperative Complications; D009435:Synaptic Transmission
D009466:Neuromuscular Blocking Agents