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British Journal of Anaesthesia
Article
License: Elsevier Non-Commercial
Data sources: UnpayWall
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British Journal of Anaesthesia
Article . 2010 . Peer-reviewed
License: Elsevier Non-Commercial
Data sources: Crossref
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Postoperative residual curarization from intermediate-acting neuromuscular blocking agents delays recovery room discharge

Authors: Butterly, Arielle D.; Bittner, Edward A.; George, Edward E.; Sandberg, Warren S.; Eikermann, Matthias; Schmidt, Ulrich H.;

Postoperative residual curarization from intermediate-acting neuromuscular blocking agents delays recovery room discharge

Abstract

Postoperative residual curarization (PORC) [train-of-four ratio (T4/T1) <0.9] is associated with increased morbidity and may delay postoperative recovery room (PACU) discharge. We tested the hypothesis that postoperative T4/T1 <0.9 increases PACU length of stay.At admission to the PACU, neuromuscular transmission was assessed by acceleromyography (stimulation current: 30 mA) in 246 consecutive patients. The potential consequences of PORC-induced increases in PACU length of stay on PACU throughput were estimated by application of a validated queuing model taking into account the rate of PACU admissions and mean length of stay in the joint system of the PACU plus patients recovering in operation theatre waiting for PACU beds.PACU length of stay was significantly longer in patients with T4/T1 <0.9 (323 min), compared with patients with adequate recovery of neuromuscular transmission (243 min). Age (P=0.021) and diagnosis of T4/T1 <0.9 (P=0.027), but not the type of neuromuscular blocking agent, were independently associated with PACU length of stay. The incidence of T4/T1 <0.9 was higher in patients receiving vecuronium. Delayed discharge significantly increases the chances of patients having to wait to enter the PACU. The presence of PORC is estimated to be associated with significant delays in recovery room admission.PORC is associated with a delayed PACU discharge. The magnitude of the effect is clinically significant. In our system, PORC increases the chances of patients having to wait to enter the PACU.

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Keywords

Adult, Aged, 80 and over, Male, Vecuronium Bromide, Adolescent, Medizin, Neuromuscular Junction, Length of Stay, Middle Aged, Young Adult, Anesthesia Recovery Period, Atracurium, Neuromuscular Blockade, Humans, Female, Postoperative Period, Prospective Studies, Neuromuscular Blocking Agents, Aged, Monitoring, Physiologic

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    popularity
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    influence
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
172
Top 1%
Top 1%
Top 1%
hybrid