Davis, Cherian (2016) Incidence and Risk Factors for Residual Neuromuscular Blockade in Post Anaesthesia Care Unit among Patients Receiving Intermediate Acting Neuromuscular Blocking Drugs. Masters thesis, Christian Medical College, Vellore.
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Abstract
OBJECTIVES : To determine the incidence and risk factors of residual neuromuscular blockade (defined as TOF ratio <0.9), identify the risk factors and measure the morbidity associated with it . METHODS : 195 ASA 1-3 adults scheduled to undergo elective surgeries were included in the study. Sample size was calculated with an expected prevalence of 40%. Incidence of residual RNMB defined as TOF ratio <0.9 was measured using TOF watch SX. Demographic data, intraoperative events, TOF ratio and clinical signs of recovery were monitored. Data was entered in EPIDATA version 3.1 and analyzed using statistical software SPSS (version 18.0). Risk factors were analyzed using univariate and multivariate analysis. RESULTS : Incidence of residual NMB was 31% with a TOF ratio of < 0.9. Female gender, BMI > 25 and hypothermia were identified as risk factors. Residual neuromuscular blockade was shown to be associated with increased use of airway adjuncts in the recovery. The commonly used clinical tests were not sensitive to pick up RNMB. CONCLUSION ; Residual neuromuscular block defined as a TOF ratio < 0.9 is a significant problem with an incidence of 31%. Incidence of residual NMB was 51% using the current recommendation of TOF ratio ≥ 1 using accelomyography. Female sex and patients with BMI > 25 and hypothermia were identified as risk factors for developing residual neuromuscular block. Patients with residual NMB had significantly high requirement for the use of airway adjuncts. Clinical test like head lift and hand grip for 5 seconds are not sensitive to reliably exclude residual neuromuscular block.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | Incidence, Risk Factors, Residual Neuromuscular Blockade, Post Anaesthesia Care Unit, Intermediate Acting Neuromuscular Blocking Drugs. |
| Subjects: | MEDICAL > Anaesthesiology |
| Depositing User: | Subramani R |
| Date Deposited: | 06 Jan 2018 16:34 |
| Last Modified: | 06 Jan 2018 16:34 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/5335 |
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