Izvorni znanstveni članak
https://doi.org/10.22514/SV141.042018.10
Neuromuscular blockade in clinical practice in paediatric anaesthesia: retrospective cohort trial in a tertiary paediatric anaesthesia centre
PETR ŠTOURAČ
orcid.org/0000-0003-1944-5926
; Department of Paediatric Anaesthesiology and Intensive Care Medicine University Hospital Brno Jihlavska 20, Brno, 625 00 Czech Republic
JOZEF KLUČKA
MICHAELA ŤOUKALKOVÁ
IVO KŘIKAVA
ROMAN ŠTOUDEK
EVA KLABUSAYOVÁ
MÁRIA MORAVSKÁ
Sažetak
Background. Neuromuscular blockade is
associated with improved airway conditions
for intubation and superior conditions
for surgical interventions (predominantly
important in laparoscopic surgery).
Residual neuromuscular blockade in the
postoperative period is, according to recently
published data, associated with a
negative impact on perioperative morbidity
and mortality.
Aim. Te aim of the study was to describe
daily practice in clinical paediatric anaesthesia
in a tertiary children’s hospital.
Methods. Data from anaesthesiology
records during the period 1.1.2016 to
31.12.2016 were retrospectively screened.
Primary outcomes included the rate of
surgery cases with neuromuscular blockade,
the incidence of cases with perioperative
neuromuscular blockade monitoring
and the incidence of neuromuscular
pharmacologic block reversal. Secondary
outcomes were myorelaxant usage according
to the age of patients and duration of
surgery.
Results. Overall 8046 paediatric patients
underwent general anaesthesia in the study
period. Muscle relaxants were administered
in 1650 cases (20.5%). Te most frequently
administered muscle relaxant was
mivacurium (48.2 %, n=795), followed by
cis-atracurium (36.4 %, n=601), suxamethonium
(10.3 %, n=170) and rocuronium
(7.0 %, n=115). Neuromuscular blockade
monitoring was used only in 2.5% (n=41)
of cases. Active neuromuscular blockade
reversal was administered in 5.8% (n=95)
of cases.
Conclusion. Neuromuscular blockade in
paediatric anaesthesia was less frequent
compared to adults. Te low rate of neuromuscular
blockade monitoring in combination
with the low rate of active block reversal
can be considered dangerous due to
the relatively high risk of potential residual
postoperative blockade, that can negatively
influence clinical outcome.
Ključne riječi
neuromuscular blocking agent; paediatric anaesthesia; residual blockade; neuromuscular blockade
Hrčak ID:
200438
URI
Datum izdavanja:
1.6.2018.
Posjeta: 852 *