دراسة مقارنة بين استخدام المعايير السريرية و حث العصب المحيطي في مراقبة الحصار العصبي العضلي

الملخص EN

Background & Objective: incomplete recovery from non-depolarizing neuromuscular blocking agents (which is called postoperative residual curarization)( PORC) Continues to be a problem in modern recovery units .

This study aims to compare using clinical criteria and peripheral nerve stimulation in monitoring intra operative neuromuscular blockade and postoperative residual curarization .

Methods & Materials: sixty ASAI or ASAװ patients were enrolled prospectively and randomly and were divided into two groups A,B.

Anesthesia was induced using rocuronium 0.6mg/kg for intubation and 0.15mg/kg for maintenance doses in all patients.

Clinical criteria were used to monitor neuromuscular blockade and to achieve maintenance doses of rocuronium and to extubate patients in group A .

On the other hand peripheral nerve stimulator (PNS) was used to achieve the same objectives in group B.

Diagnosis of postoperative residual curarization was achieved by using (PNS) in the measure of train of four (TOF)for both groups in the recovery room .

Results: intubation conditions were excellent in (50%,66,6%)of group A and group B respectively .

There were no difference between the two groups in the onset time of rocuronium (69،96±6.70 s,69.16±6.02 s) P value =0,41.

There were statistically significant difference in the duration of induction dose (30,50±2,18s,24,10±1,56s) P value <0.05 and in the duration of first maintenance dose (14,26±1,22s,11,46±0,93s)and the second maintenance dose (15,73±1,04s,14,26±0,90s) P value <0.05.No difference was found in duration of third maintenance dose (14.66±1.15s,14.43±1,30s) P value =0,42.

Number of patients who have had postoperative residual curarization was (7,3) (23,3%,10%) in group A ,B respectively.

Conclusion : Postoperative residual curarization is a potentially preventable safety problem .Using train of four stimulation by the peripheral nerve stimulator can reduce the number of patients with residual neuromuscular blockade in the recovery room and at the same time facilitate the work of surgeon by providing good conditions of muscle relaxation when we monitor neuromuscular function