XXXX is associated with postoperative residual curarization.

@entity1 @entity4094 @entity5159 @entity3370 @entity912
BACKGROUND: Residual @entity912 following the use of neuromuscular blocking drugs remains a clinical problem. As part of departmental quality assurance, we examined the degree of postoperative residual curarization (PORC) following @entity5159 . METHODS: Forty @entity1 undergoing general anaesthesia involving @entity5159 were studied. Quantitative neuromuscular monitoring (mechanomyography, Myograph 2000, Biometer, Denmark) was performed by assessing the response to supramaximal @entity3370 ( @entity3370 ) stimulation of the ulnar nerve. Anaesthesia was provided by non-participating clinicians who were blinded to the study data. A @entity3370 ratio </=0.7 at extubation was classified as PORC. RESULTS: At antagonism of @entity4094 , 70% (28/40) of @entity1 had a @entity3370 ratio </=0.7, and 65% (26/40) of @entity1 had a @entity3370 ratio </=0.7 at extubation. Peripheral nerve stimulator use was associated with a longer interval from antagonism of block to extubation (P=0.01), but was not associated with differences in @entity5159 dosage or a reduction in PORC at extubation. @entity1 with @entity3370 ratio </=0.7 at extubation had surgery of shorter duration [59 (SEM 6) vs 103 (9) min, P<0.001], greater doses of @entity5159 relative to the duration of surgery [6 (1) vs 11 (1) micro g kg(-1) min(-1), P<0.005], and shorter intervals from administration of last dose of @entity5159 to antagonism of @entity4094 [29 (2) vs 53 (9) min, P<0.005] and from antagonism to extubation [6 (1) vs 15 (4) min, P<0.01]. Duration of surgical procedure was the sole multivariate predictor of PORC [odds ratio 0.94 (95% confidence intervals 0.91-0.98), P<0.01]. CONCLUSIONS: PORC remains a clinical problem despite use of intermediate-duration neuromuscular blocking drugs and peripheral nerve stimulators. @entity1 undergoing procedures of short duration may be at risk of inappropriately early tracheal extubation, possibly due to work pressures. The association between suboptimal antagonism of @entity4094 and short procedures needs reinforcement during postgraduate training and departmental quality assurance.
