Bloqueo neuromuscular residual en pacientes vulnerables: complicaciones pulmonares postoperatorias a causa de obesidad y apnea obstructiva del sueño

Brull, S. J.; Fülesdi, Béla

doi:10.1016/j.redar.2019.03.005

Cited by 4 publications

(1 citation statement)

References 25 publications

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“…Our findings revealed significantly lower rocuronium dosage in the SM group compared to the conventional group, accompanied by lower time to no response, recovery time, and recovery index in the SM group, its onset time was slightly higher, and no signs of insufficient muscle relaxation occurred in either group. Reduced muscle relaxant dosage and recovery time can mitigate postoperative neuromuscular residual effects and associated respiratory complications ( 16 ), particularly beneficial for short, minimally invasive outpatient procedures such as tracheoscopic consultation. Previous studies utilizing lean body weight for muscle relaxant dosing in patients with obesity under anesthesia have also reported reduced dosage and shorter recovery time, consistent with our findings ( 14 , 17 , 18 ).…”

Section: Discussionmentioning

confidence: 99%

Feasibility of calculating rocuronium dosage by skeletal muscle weight in patients with obesity

Hu,

Li,

et al. 2024

Front. Med.

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This study aimed to investigate the dose–response relationship of rocuronium administered based on skeletal muscle weight and to assess the feasibility of calculating rocuronium dosage by skeletal muscle weight in short surgeries for patients with obesity. This single-center, randomized controlled clinical trial included 71 patients with obesity aged 28–70 years, with body fat percentages (PBF) >20% in men and > 28% in women, ASA status I-III, scheduled for tracheoscopy. Patients were randomly allocated into two groups: skeletal muscle group (SM group) received rocuronium based on the skeletal muscle content (1.0 mg/kg, n = 31), and the conventional administration group (conventional group) received rocuronium based on total body weight (0.45 mg/kg, n = 30). General anesthesia was administered using the same protocol. Parameters recorded included patients’ general condition, muscle relaxant usage, onset time of muscle relaxants, non-response time, clinical effect time, 75% recovery time, and recovery index. Additionally, occurrences of body movement, choking, and incomplete muscle relaxation during surgery were recorded. Compared to the conventional group, the SM group required significantly less rocuronium dosage, resulting in significantly lower non-response time, clinical effect time, 75% recovery time, and recovery index (p < 0.05), and the onset time is slightly longer. Neither group experienced body movement, choking, or incomplete muscle relaxation (p > 0.05). Utilizing skeletal muscle weight to calculate rocuronium dosage in short surgeries for patients with obesity can reduce dosage, shorten recovery time, and prevent residual muscle relaxation while achieving satisfactory muscle relaxation to meet surgical requirements.

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Section: Discussionmentioning

confidence: 99%

Feasibility of calculating rocuronium dosage by skeletal muscle weight in patients with obesity

Hu,

Li,

et al. 2024

Front. Med.

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Management of Neuromuscular Blockade in the Elderly and Morbidly Obese Patient: What Does the Data Show?

Renew

Naguib

2020

Curr Anesthesiol Rep

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Reversal of residual neuromuscular block with neostigmine or sugammadex and postoperative pulmonary complications: a prospective, randomised, double-blind trial in high-risk older patients

Ledowski

Szabó-Maák

Loh

et al. 2021

British Journal of Anaesthesia

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Background: Residual neuromuscular block is associated with an increased risk of postoperative pulmonary complications in retrospective studies. The aim of our study was to investigate prospectively the incidence of postoperative pulmonary complications after reversal with either sugammadex (SUG) or neostigmine (NEO) in high-risk older patients. Methods: We randomly allocated 180 older patients with significant morbidity (ASA physical status 3) !75 yr old to reversal of rocuronium with either SUG or NEO. Adverse events in the recovery room and pulmonary complications (defined by a 5-point [0e4; 0¼best to 4¼worst] outcome score) on postoperative Days 1, 3, and 7 were compared between groups. Results: Data from 168 patients aged 80 (4) yr were analysed; SUG vs NEO resulted in a reduced probability (0.052 vs 0.122) of increased pulmonary outcome score (impaired outcome) on postoperative Day 7, but not on Days 1 and 3. More patients in the NEO group were diagnosed with radiographically confirmed pneumonia (9.6% vs 2.4%; P¼0.046). The NEO group showed a non-significant trend towards longer hospital length of stay across all individual centres (combined 9 vs 7.5 days), with a significant difference in Malaysia (6 vs 4 days; P¼0.011). Conclusions: Reversal of rocuronium neuromuscular block with SUG resulted in a small, but possibly clinically relevant improvement in pulmonary outcome in a select cohort of high-risk older patients. Clinical trial registration: ACTRN12614000108617.

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Bloqueo neuromuscular residual en pacientes vulnerables: complicaciones pulmonares postoperatorias a causa de obesidad y apnea obstructiva del sueño

Cited by 4 publications

References 25 publications

Feasibility of calculating rocuronium dosage by skeletal muscle weight in patients with obesity

Feasibility of calculating rocuronium dosage by skeletal muscle weight in patients with obesity

Management of Neuromuscular Blockade in the Elderly and Morbidly Obese Patient: What Does the Data Show?

Reversal of residual neuromuscular block with neostigmine or sugammadex and postoperative pulmonary complications: a prospective, randomised, double-blind trial in high-risk older patients

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