title: Postoperative residual paralysis in outpatients versus inpatients.
abstract: 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.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, OLV Clinic, Aalst, Belgium. guy.cammu@olvz-aalst.be
authors.forename: Guy
authors.initials: G
authors.lastname: Cammu
authors.forename: Jan
authors.initials: J
authors.lastname: De Witte
authors.forename: Jan
authors.initials: J
authors.lastname: De Veylder
authors.forename: Geert
authors.initials: G
authors.lastname: Byttebier
authors.forename: Dirk
authors.initials: D
authors.lastname: Vandeput
authors.forename: Luc
authors.initials: L
authors.lastname: Foubert
authors.forename: Geert
authors.initials: G
authors.lastname: Vandenbroucke
authors.forename: Thierry
authors.initials: T
authors.lastname: Deloof
mesh_terms: 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
chemical_list: D009466:Neuromuscular Blocking Agents