Document Detail

Postoperative residual neuromuscular blockade is associated with impaired clinical recovery.
MedLine Citation:
PMID:  23337416     Owner:  NLM     Status:  MEDLINE    
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.
Glenn S Murphy; Joseph W Szokol; Michael J Avram; Steven B Greenberg; Torin Shear; Jeffery S Vender; Jayla Gray; Elizabeth Landry
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2013-01-21
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  117     ISSN:  1526-7598     ISO Abbreviation:  Anesth. Analg.     Publication Date:  2013 Jul 
Date Detail:
Created Date:  2013-06-21     Completed Date:  2013-08-27     Revised Date:  2014-04-03    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  133-41     Citation Subset:  AIM; IM    
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MeSH Terms
Anesthesia Recovery Period*
Kinetocardiography / methods
Middle Aged
Muscle Weakness / diagnosis*,  physiopathology*
Neuromuscular Blockade / adverse effects*
Neuromuscular Monitoring / methods
Postoperative Complications / diagnosis*,  physiopathology*
Comment In:
Anesth Analg. 2014 Mar;118(3):692-3   [PMID:  24557118 ]
Anesth Analg. 2014 Mar;118(3):691   [PMID:  24557116 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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