skip to main content
Language:
Search Limited to: Search Limited to: Resource type Show Results with: Show Results with: Search type Index

The Incidence of Residual Neuromuscular Block in Pediatrics: A Prospective, Pragmatic, Multi-institutional Cohort Study

Curēus (Palo Alto, CA), 2024-03, Vol.16 (3), p.e56408-e56408 [Peer Reviewed Journal]

Copyright © 2024, Faulk et al. ;Copyright © 2024, Faulk et al. This work is published under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;Copyright © 2024, Faulk et al. 2024 Faulk et al. ;ISSN: 2168-8184 ;EISSN: 2168-8184 ;DOI: 10.7759/cureus.56408 ;PMID: 38638790

Full text available

Citations Cited by
  • Title:
    The Incidence of Residual Neuromuscular Block in Pediatrics: A Prospective, Pragmatic, Multi-institutional Cohort Study
  • Author: Faulk, Debra J ; Karlik, Joelle B ; Strupp, Kim M ; Tran, Stephanie M ; Twite, Mark ; Brull, Sorin J ; Yaster, Myron ; Austin, Thomas M
  • Subjects: African Americans ; Anesthesia ; Anesthesiology ; Body mass index ; Children & youth ; Clinical medicine ; Demographics ; Drug dosages ; Electromyography ; Hospitals ; Medical personnel ; Patients ; Pediatric Surgery ; Pediatrics ; Regression analysis ; Surgery ; Variables ; Ventilators
  • Is Part Of: Curēus (Palo Alto, CA), 2024-03, Vol.16 (3), p.e56408-e56408
  • Description: Introduction Residual neuromuscular block, defined as a quantitatively measured train-of-four ratio (TOFr) <0.9, is common postoperatively. Using a pragmatic trial design, we hypothesized that qualitative and/or clinical assessment of neuromuscular block would inadequately detect residual block following antagonism with neostigmine or sugammadex. Method After IRB approval and written informed consent, 74 children (aged 2-17 years), undergoing elective surgery and receiving rocuronium, were prospectively enrolled in the study at Children's Hospital Colorado and Children's Healthcare of Atlanta. Routine clinical practice at both institutions consisted of clinical signs and/or qualitative assessment with peripheral nerve stimulators. Children at the Colorado hospital routinely received sugammadex antagonism; whereas children at the Atlanta hospital received neostigmine. Residual neuromuscular block was assessed postoperatively using quantitative electromyography. If TOFr was <0.9, patients received sugammadex until TOFr ≥0.9. Result Qualitative and clinical assessment failed to detect residual block in 29.7% of patients in the neostigmine reversal cohort (adjusted odds ratio (aOR) 29.8, 95% confidence interval (CI): 2.7 to 5,559.5, p-value = 0.002). No residual block was detected in the sugammadex reversal cohort. A correlation between increasing patient weight and incidence of postoperative residual block was observed in the neostigmine cohort (aOR 1.05, 95% CI: 1.02 to 1.10, p-value = 0.002). Conclusion Qualitative and/or clinical assessment of neuromuscular block inadequately detects residual block following neostigmine antagonism.
  • Publisher: United States: Cureus Inc
  • Language: English
  • Identifier: ISSN: 2168-8184
    EISSN: 2168-8184
    DOI: 10.7759/cureus.56408
    PMID: 38638790
  • Source: PubMed Central
    ProQuest Central
Back to results list
INSPIRE LIBRARY - TON DUC THANG UNIVERSITY (84-028) 37 755 057 Feedback
19 Nguyen Huu Tho St. Dist.7, HCM thuvien@tdtu.edu.vn

Copyright © 2017 INSPIRE LIBRARY - TON DUC THANG UNIVERSITY

Searching Remote Databases, Please Wait