TY - JOUR
T1 - Postoperative residual neuromuscular blockade is associated with impaired clinical recovery
AU - Murphy, Glenn S.
AU - Szokol, Joseph W.
AU - Avram, Michael J.
AU - Greenberg, Steven B.
AU - Shear, Torin
AU - Vender, Jeffery S.
AU - Gray, Jayla
AU - Landry, Elizabeth
PY - 2013/7
Y1 - 2013/7
N2 - BACKGROUND: In this investigation, we sought to determine the association between objective evidence of residual neuromuscular blockade (train-of-four [TOF] ratio <0.9) and the type, incidence, and severity of subjective symptoms of muscle weakness in the postanesthesia care unit (PACU). METHODS: TOF ratios of 149 patients were quantified with acceleromyography on arrival to the PACU. Patients were stratified into 2 cohorts: a TOF <0.9 group (n = 48) or a TOF ≥0.9 (control) group (n = 101). A standardized examination determined the presence or absence of 16 symptoms and 11 signs of muscle weakness on arrival to the PACU and 20, 40, and 60 minutes after admission. RESULTS: The incidence of symptoms of muscle weakness was significantly higher in the TOF <0.9 group at all times (P < 0.001), as was the median (range) number of symptoms from PACU arrival (7 [3-6] TOF <0.9 group vs 2 [0-11] control group; difference 5, 99% confidence interval of the difference 4-6) until 60 minutes after admission (2 [0-12] TOF <0.9 group vs 0 [0-11] control group; difference 2, 99% confidence interval of the difference 1-2) (all P < 0.0001). CONCLUSION: The incidence and severity of symptoms of muscle weakness were increased in the PACU in patients with a TOF <0.9.
AB - BACKGROUND: In this investigation, we sought to determine the association between objective evidence of residual neuromuscular blockade (train-of-four [TOF] ratio <0.9) and the type, incidence, and severity of subjective symptoms of muscle weakness in the postanesthesia care unit (PACU). METHODS: TOF ratios of 149 patients were quantified with acceleromyography on arrival to the PACU. Patients were stratified into 2 cohorts: a TOF <0.9 group (n = 48) or a TOF ≥0.9 (control) group (n = 101). A standardized examination determined the presence or absence of 16 symptoms and 11 signs of muscle weakness on arrival to the PACU and 20, 40, and 60 minutes after admission. RESULTS: The incidence of symptoms of muscle weakness was significantly higher in the TOF <0.9 group at all times (P < 0.001), as was the median (range) number of symptoms from PACU arrival (7 [3-6] TOF <0.9 group vs 2 [0-11] control group; difference 5, 99% confidence interval of the difference 4-6) until 60 minutes after admission (2 [0-12] TOF <0.9 group vs 0 [0-11] control group; difference 2, 99% confidence interval of the difference 1-2) (all P < 0.0001). CONCLUSION: The incidence and severity of symptoms of muscle weakness were increased in the PACU in patients with a TOF <0.9.
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U2 - 10.1213/ANE.0b013e3182742e75
DO - 10.1213/ANE.0b013e3182742e75
M3 - Article
C2 - 23337416
AN - SCOPUS:84880570017
SN - 0003-2999
VL - 117
SP - 133
EP - 141
JO - Anesthesia and analgesia
JF - Anesthesia and analgesia
IS - 1
ER -