 |
 |
 |
 |
 |
|
Clinical Window Educational Program is sponsored by GE Healthcare
Clinical Window Web Journal complies with the HON code standard for trustworthy health information: verify here.
Educational collaboration:
Clinical Window is main sponsor for this concise, textbook style website of anaesthesiology
 |
 |
Anesthesia, Evidence and
Experience |
|
NMT monitoring: an absolute necessity in anesthesia practice
 |
Dr. G. Cammu, MD |
The article also available in 
PDF:
73KB
Editor's comments: This abstract accompanies the Clinical Window presentation at the 13th World Congress of Anaesthesiologists in Paris, France April 22-24 2004. Please see also CWWJ's Internet podium area in the same issue (17), where you will find the author's presentation slides You may find it interesting to visit our previous issues with a similar topic, as well.
Ilkka Kalli, MD, Editor-in-Chief |
Postoperative residual curarization (PORC)
Neuromuscular blocking drugs are often used in anesthesia; in some types of surgery, their continuous infusion is indicated to limit the otherwise high incidence of movement. A large amount of postoperative residual curarization is found after a single bolus, but more especially when continuous infusions are used in healthy patients and even more so in those with organ dysfunction or undergoing special types of surgery.
Monitoring neuromuscular block optimizes drug administration
Therefore, one should always optimize the dose requirements over time using neuromuscular transmission monitoring. Such monitoring should also help the clinician to selectively antagonize the neuromuscular block at the end of surgery. The author feels that one should probably avoid routine antagonization, especially in certain subgroups of patients, until a selective and safe reversal agent has been developed. At present, then, the only objective and reliable guide to facilitating the decision for selective antagonization is the neuromuscular transmission monitor.
Recent data and editorials warning about postoperative residual curarization after boluses and infusions of neuromuscular blocking drugs have made residual curarization one of the most feared complications in anesthesia. There may be a consequent issue of malpractice if neuromuscular transmission monitoring is not used and/or pharmacological antagonization is not performed.
More reading:
Cammu G, Postoperative residual curarization with cisatracurium and rocuronium infusions (CWWJ Issue 13, July 2003)
Dr. Cammu at the WCA 2004 in Paris
Last updated: 9 July 2004 Created |
||
|
||
| Legal notice | © GE
Healthcare 2008 ISSN 1795-6269 (Web) ISSN 1795-6277 (CD) |
Webmaster |
 |
|
|
Tailor-made
Anesthesia |
 |
|
 |
|
|
 Read stories from our short historic account of milestones in anesthesiology. |
|
|