A Survey of Muscle Relaxants Used for Cardiac Anaesthesia in the United Kingdom

Abstract

A questionnaire survey was conducted of 310 consultant cardiac anaesthetists in the United Kingdom. We asked which nondepolarising muscle relaxants they preferred for fast-track and non-fast-track patients, and how neuromuscular function was assessed prior to extubation. There was a 73% response rate. A single agent non-depolarising muscle relaxant technique was most prevalent. Pancuronium (either alone or in combination with another agent) was the first choice for non-fast-track and fast-track patients (74% and 54% respectively). A minority of anaesthetists (23%) modified their choice of nondepolarising muscle relaxant for fast-track patients; changing from pancuronium to a shorter-acting agent was the commonest adaptation. Twenty one percent of respondents indicated that an assessment of neuromuscular function was performed as part of an extubation protocol. Objective monitoring of neuromuscular function was only reported by a small minority (9% in theatre and 5% pre-extubation). This survey is the first part of a national audit of non-depolarising muscle relaxant use and monitoring in cardiac anaesthesia.