ISSN (print) 1726-9806     ISSN (online) 1818-474X
No. 1 (2017), ANESTHESIOLOGY
No. 1 (2017)
ANESTHESIOLOGY

Monitoring of Muscle Relaxation in Routine Anesthesia Practice: Three-year Experience

Published 24.03.2017
Sergey Vyacheslavovich Chuprin
Kuban State Medical University, Krasnodar, Russia
https://orcid.org/0000-0003-0516-6395
O.V. Sushkova
Kuban State Medical University, Krasnodar, Russia
https://orcid.org/0000-0002-5709-0153
L.N. Girinskaia
Kuban State Medical University, Krasnodar, Russia
https://orcid.org/0000-0002-5250-9904
S.A. Kuznetsov
Kuban State Medical University, Krasnodar, Russia
https://orcid.org/0000-0002-5434-527X
V.V. Myasnikova
S.N. Fyodorov IRTC «Eye Microsurgery», Krasnodar, Russia
https://orcid.org/0000-0003-1748-7962
#20171
PDF_2017-1_24-28 (Russian)

Keywords

muscle relaxants
neuromuscular block
neuromuscular monitoring
TOF-mode
reversion

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1.
Chuprin S.V., Sushkova O.V., Girinskaia L.N., Kuznetsov S.A., Myasnikova V.V. Monitoring of Muscle Relaxation in Routine Anesthesia Practice: Three-year Experience. Annals of Critical Care. 2017;(1):24-28. doi:10.21320/1818-474X-2017-1-24-28
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Abstract

Neuromuscular block is a really significant component of anesthesia during surgery operations. At this time, individual sensitivity to neuromuscular blocking differs considerably and depends on great number of factors. The main task of conduct of neuromuscular monitoring is exclusion of residual block and recovery of neuromuscular conductivity. We present analysis of three years’ experience of application of monitoring of neuromuscular conductivity. The aim of the research is the estimation of effectiveness of usage of monitoring of neuromuscular conductivity in daily practice of anesthesia service for provision of patients’ security and formation of comfortable conditions for surgeons’ work. Materials and methods. In our research, we included 4459 patients who had operating treatment under general anesthesia. All the patients were divided in two groups. In the first group (2355 patients) during anesthesia there used monitor TOF-Watch SX (Organon, Ireland). In the second group (2104 patients) monitoring of neuromuscular conductivity was not performed. Results. The received results lead to the conclusion that application of monitoring of neuromuscular conductivity allowed to decrease statistically number of incidents connected with insufficient neuromuscular blocking or impaired reversion of neuromuscular block. Absence of statistically considerable differences in quantity of hyperdynamic reactions in the circulatory system connected with intubation, probably, is caused by great quantity of heterogeneous factors of influence on this index. Also, application of monitor of neuromuscular conductivity made it possible to conform to a surgeon’s expectations, ensuring muscular relaxation suitable for surgery conditions. Conclusion. Usage of monitors of neuromuscular conductivity in routine anesthesia practice is necessary and essential for ensuring patients’ security and creation of comfortable conditions for surgeons work.

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References

  1. Миллер Р. Анестезия Рональда Миллера: Пер. с англ. Под общ. ред. К.М. Лебединского: В 4 т. СПб.: Человек, 2015. Т. 2. [Miller R. Miller’s anaesthesia. Ed.: K.M. Lebedinskiy. Saint Petersburg: Chelovek, 2015. Vol. 2. (In Russ)]
  2. Морган Дж.Э. мл., Михаил М.С., Марри М.Дж. Клиническая анестезиология. Кн. 1. М.: Бином, 2013. [Morgan G.E, Mikhail M.S., Murray M.J. Clinical anesthesiology. Vol. 1. Moscow: Binom, 2013. (In Russ)]
  3. Управление нейромышечным блоком в анестезиологии. Клинические рекомендации ФАР. Под. ред. Е.С. Горобца, В.М. Мизикова, Э.М. Николаенко. М.: ГЭОТАР-Медиа, 2014. [Neuromuscular block management in anesthesiology. FAR clinical guidelines. Eds.: E.S. Gorobets, V.M. Mizikov, E.M. Nikolaenko. Moscow: GEOTAR-Media, 2014. (In Russ)]
  4. Arain S.R., Kern S., Ficke D.J. et al. Variability of duration of action of neuromuscular-blocking drugs in elderly patients. Acta Anaesthesiol. Scand. 2005; 49: 312– doi: 10.1111/j.1399-6576.2005.00634.x.
  5. Blobner M., Eriksson L.I., Scholz J. et al. Reversal rocuroniuminduced neuromuscular blockade with sugammadex compared with neostigmine during sevofluraneanaesthesia: results of a randomized, controlled trial. Eur. J. Anaesthesiol. 2010; 27(10): 874–881. doi: 10.1097/EJA.0b013e32833d56b7.
  6. Chui P.T., Gin T., Oh T.E. Anaesthesia for laparoscopic general. Anaesth. Intensive Care. 1993; 21: 163–171.
  7. Claudius C., Garvey L.H., Viby-Mogensen J. The undesirable effects of neuromuscular blocking drugs. Anaesthesia. 2009; 64(Suppl 1): 10– doi: 10.1111/j.1365-2044.2008.05866.x.
  8. Dubois P.E., Putz L., Jamart J. et al. Deep neuromuscular block improves surgical conditions during laparoscopic hysterectomy: A randomised controlled trial. Eur. J. Anaesthesiol. 2014; 31: 430–436. doi: 10.1097/EJA.0000000000000094.
  9. Fujimoto M., Tanahira C., Yamamoto M. In non-obese patients, duration of action of rocuroniumis directly correlated with body mass index. Canadian Journal of Anesthesia. 2013; 60(6): 552–556. doi: 10. 1007/s12630-013-9914-x.
  10. Grosse-Sundrup M., Henneman J.P., Sandberg W.S. et al. Intermediate acting non-depolarizing neuromuscular blocking agents and risk of postoperative respiratory complications: prospective propensity score matched cohort study. British Medical Journal. 2012; 345: e6329. doi: 10.1136/bmj.e6329.
  11. Gurusamy K.S., Samraj J.K., Davidson B.R. Low pressure versus standard pressure pneumoperitoneum in laparoscopic cholecystectomy. Cochrane Database of Systematic Reviews. 2009; 2. Art. No: CD006930. doi: 10.1002/14651858.CD006930.pub2.
  12. King M., Sujirattanawimol N., Danielson D.R. Requirements for muscle relaxants during radical retropubic prostatectomy. Anesthesiology. 2000; 93: 1392–1397.
  13. Martini C.H., Boon M., Bevers R.F. et al. Evaluation of surgical conditions during laparoscopic surgery in patients with moderate vs deep neuromuscular block. Br. J. Anaesth. 2014; 112: 498– doi: 10.1093/bja/aet377.
  14. Martyn J.A., Fagerlund M.J., Eriksson L.I. Basic principles of neuromuscular transmission. Anaesthesia. 2009; 64(Suppl 1): 1–9. doi: 10.1111/j.1365-2044.2008.05865.x.
  15. Murphy G.S., Brull S.J. Residual neuromuscular block: lessons unlearned. Part I: definitions, incidence, and adverse physiologic effects of residual neuromuscular block. Anesth. Analg. 2010; 111(1): 120–
  16. Nguyen J.H., Tanaka P.P. Anesthesia for Laparoscopic Surgery. In: Wetter P.A., ed. Prevention and Management of Laparoendoscopic Surgical Complications. 2nd Society of Laparoendoscopic Surgeons. 2011.
  17. Welliver M., McDonough J., Kalynych N. et al. Discovery, development, and clinical application of sugammadex sodium, a selective relaxant binding agent. Drug Des. Devel. Ther. 2009; 2: 49–59.
  18. Xiaobo F., Jianjuan K., Yanlin W. Comparison of the variability of the onset and recovery from neuromuscular blockade with cisatracurium versus rocuronium in elderly patients under total intravenous anesthesia. Brazilian Journal of Medical and Biological Research. 2012; 45: 676–680. doi: 10.1590/S00100-879X2012007500076.
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