Evidence Based Practice and Quality Assurance
Background and Goal of Study: Different clinical sings have variable values in predicting neuromuscular blockade (NMB) recovery (1,2). The goal of this study was to exam if clinical sings of NMB recovery could be used as guideline for safety reversal assessment in absence of adequate and objective NMB monitoring.
Materials and Methods: We have investigated 45 ASA I or II patients, during propofol-fentanyl anesthesia and pancuronium induced NMB. The patients were randomly allocated into 3 groups of 15, based on reappearance of the second (Group I), third (Group II), or fourth (Group III) TOF response in each anesthesia. NMB was evaluated by electromyography at the adductor pollicis muscle using a Datex Relaxograph® (T1, TOFr, number of TOF responses). Before neostigmine was administered, we evaluated the quality (poor, medium, good) of clinical sings that suggest NMB recovery such as: eye opening, tongue protrusion, ability to sustain arm lift >15 sec and head lift >5 sec.
Results and Discussions: Data are shown in Table.
Conclusion(s): Eye opening and tongue protrusion might be used as guideline for safety reversal assessment.
1 Hayes AH. et al. Anaesthesia, 2001; 56: 312-8.
2 Debaene B. et al. Anesthesiology, 2003; 98: 1042-8.