title: [Reporting of muscle relaxant effects in anaesthesia files concerning visceral surgery - a observational and multicenter study].
abstract: OBJECTIVE
  To report any item documenting the peroperative muscle relaxant effects management in anaesthesia files issued from visceral surgery processes.
  
  
  METHODS
  Prospective, observational and multicenter.
  
  
  METHODS
  A single operator analysed 1453 files proposed by nine anaesthetists' teams. The items selected concerned three periods: induction/tracheal intubation, paralysis maintenance, tracheal extubation. Reporting of 40 categories of items was studied.
  
  
  RESULTS
  Items related to laryngoscopy and intubation conditions were observed in 43% (0-95) [general average (intercentres min-max)] and in 11% (0-97) of the files, respectively. At least one level of paralysis was reported in 23% (0-96) of the files. For the paralysis maintenance, documentation of an effect appeared in 53% (4-96) of the documents. Neuromuscular assessments preceding the tracheal extubation were retrieved in 43% (12-89) of the notes. Adductor pollicis was concerned for 30% (1-89) of these observations. Detection of level of spontaneous paralysis offset, satisfying to the local standard, appeared in 14% (3-19) of the documents. Pharmacological reversal was noted for 25% (4-67) of the patients; the assessment of the effects so produced was reported in 8% (0-58).
  
  
  CONCLUSIONS
  In the studied collection, the traceability of the peranaesthetic curarization management appears variable on both qualitative and quantitative levels. The emergence of a dedicated guideline - defining the criteria for producing a good documentation of the muscle relaxant use - becomes necessary to secure these practices for all physicians using muscle relaxants.
authors.affiliation: Service d'anesthésiologie, hôpital universitaire Cantonal, Genève, Suisse. dhollanderalain@yahoo.fr
authors.forename: A
authors.initials: A
authors.lastname: d'Hollander
authors.forename: C
authors.initials: C
authors.lastname: Baillard
authors.forename: G
authors.initials: G
authors.lastname: Gehan
authors.forename: E
authors.initials: E
authors.lastname: Samain
authors.forename: D
authors.initials: D
authors.lastname: Sirieix
authors.forename: B
authors.initials: B
authors.lastname: Debaene
authors.forename: S
authors.initials: S
authors.lastname: Nafeh
authors.forename: C
authors.initials: C
authors.lastname: Motamed
authors.forename: B
authors.initials: B
authors.lastname: Plaud
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D060666:Airway Extubation; D000758:Anesthesia; D004282:Documentation; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000187:drug effects; D003473:Neuromuscular Nondepolarizing Agents / Q000009:adverse effects / Q000494:pharmacology*; D010243:Paralysis / Q000139:chemically induced; D019990:Perioperative Care; D011446:Prospective Studies; D013514:Surgical Procedures, Operative; D055815:Young Adult
chemical_list: D003473:Neuromuscular Nondepolarizing Agents