The adequate rocuronium dose required for complete block of the adductor muscles of the thigh

Fujimoto, Masafumi; Kawano, Kenshiro; Yamamoto, Tatsuo

doi:10.1111/aas.13045

Cited by 5 publications

(3 citation statements)

References 15 publications

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“…Another potential explanation for the observed lack of benefit from deep NMB in this patient population may be differential effects of NMB on different muscle groups in the body. One recent study which examined the rocuronium dose required to block direct obturator nerve stimulation of adductor muscles of the thigh found that complete blockade of the thigh adductors was achieved before TOF count responses in the adductor pollicis were suppressed [12]. We measured depth of NMB at the adductor pollicis and thus cannot rule out the possibility that the response of this muscle to NMB may have differed to the response of muscles, affecting the operative site during minimally invasive ALTHA.…”

Section: Discussionmentioning

confidence: 91%

Does Deep Neuromuscular Blockade Improve Operating Conditions during Minimally Invasive Anterolateral Total Hip Replacements?: A Randomized Controlled Trial

Curry¹,

Steen²,

Craig³

et al. 2020

Cureus

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Background Neuromuscular blockade (NMB) is thought to improve operative conditions during certain procedures. Published descriptions of minimally invasive hip replacement techniques specify the need for "excellent relaxation", however, the optimal degree of NMB required for such cases has not been studied. We performed a randomized, single-blind study comparing the effect of moderate and deep neuromuscular blockade on surgical conditions and operating time during minimally invasive anterolateral hip replacement. Vecuronium was administered to maintain moderate NMB (train-of-four count of 1-2) or deep NMB (train-of-four count of 0, post-tetanic count of 1-2). Methods In this study, 116 patients were randomized to receive moderate or deep neuromuscular blockade; depth of blockade was monitored using acceleromyography. The primary outcome was the number of requests from the surgeon for additional blockade intraoperatively. Secondary outcomes included operative times and assessment of the operative conditions by the surgeon utilizing the Leiden-Surgical Rating Scale. Results Cases with additional requests for blockade did not differ between the deep and moderate NMB groups (11/58, 19.0% vs 8/58, 13.8%); relative risk, 1.22 (95% CI [confidence interval], 0.70-2.15), p=0.62. Neither time from incision to prosthesis reduction (33.8±1.2 min vs. 32.6 ±1.2 min; difference in geometric mean, 0.96 [95% CI, 0.90-1.04] minutes, p=0.33), nor the surgeon's assessment of operative conditions (p=0.88), differed between the deep or moderate NMB groups, respectively. Conclusions Deep NMB did not produce significantly improved operative conditions compared with moderate NMB. Routine use of deep NMB during minimally invasive anterolateral hip arthroplasty is not supported by this study.

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Section: Discussionmentioning

confidence: 91%

Does Deep Neuromuscular Blockade Improve Operating Conditions during Minimally Invasive Anterolateral Total Hip Replacements?: A Randomized Controlled Trial

Curry¹,

Steen²,

Craig³

et al. 2020

Cureus

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“…Second, the present study was limited to studying the effect of moderate neuromuscular blockade on the transition of ventilatory leak and sealing pressure. There are situations when the surgeon asks for the patient to be even more relaxed which may lead to intense neuromuscular blockade (eg preventing the obturator jerk during transurethral resection of bladder tumours) when utilizing a supraglottic airway device 23 . Consequently, studies investigating the correlation between higher doses of rocuronium and the transition of sealing pressures are necessary.…”

Section: Discussionmentioning

confidence: 99%

The effect of rocuronium on ventilatory leak and sealing pressure using a supraglottic airway device: A randomized clinical trial

Fujimoto¹,

Kubota²,

Yamamoto

2020

Acta Anaesthesiol Scand

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Supraglottic airway devices are established tools in clinical anaesthesia practice, and short surgeries that do not require tracheal intubation is a relevant indication for the use of such devices. They can be inserted without the use of neuromuscular blocking agents and even used during mechanical ventilation. Although avoidance of neuromuscular blockade is one of the specific advantages of supraglottic devices, 1 neuromuscular blockade is sometimes required during the intraoperative period to improve surgical conditions (eg to prevent the obturator jerk during transurethral resection of bladder tumours). When neuromuscular blocking agents were administered

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“…Этого добиться практически невозможно даже при наличии мониторинга нервно-мышечной проводимости и достаточного выбора мышечных релаксантов. По данным большинства исследователей, рефлекс запирательного нерва сохраняется даже в условиях общей анестезии с мышечными релаксантами [7][8][9][10].…”

Section: Discussionunclassified

The first experience of using obturator nerve block to prevent spasm of adductor muscles of the thigh during transurethral resection of bladder

Rychkov¹,

Гаряев²,

Матвеев³

et al. 2019

Onkourologiâ

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Цель исследования-изучение возможности применения блокады запирательного нерва под контролем нейростимулятора для предупреждения спазма приводящих мышц бедра при трансуретральной резекции мочевого пузыря. Материалы и методы. В проспективное рандомизированное исследование включены данные, полученные при хирургическом лечении 50 больных, которым в связи с новообразованием, расположенным на боковой стенке мочевого пузыря, была выполнена трансуретральная резекция мочевого пузыря. Пациентам контрольной группы (группа ОА; n = 25) проводили общую анестезию с использованием миорелаксантов, исследуемой группы (группа НС; n = 25)-спинальную анестезию в сочетании с блокадой запирательного нерва 2 % раствором лидокаина 10 мл под контролем нейростимуляции.

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The adequate rocuronium dose required for complete block of the adductor muscles of the thigh

Cited by 5 publications

References 15 publications

Does Deep Neuromuscular Blockade Improve Operating Conditions during Minimally Invasive Anterolateral Total Hip Replacements?: A Randomized Controlled Trial

Does Deep Neuromuscular Blockade Improve Operating Conditions during Minimally Invasive Anterolateral Total Hip Replacements?: A Randomized Controlled Trial

The effect of rocuronium on ventilatory leak and sealing pressure using a supraglottic airway device: A randomized clinical trial

The first experience of using obturator nerve block to prevent spasm of adductor muscles of the thigh during transurethral resection of bladder

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