Neuromuscular blockade in clinical practice in paediatric anaesthesia: retrospective cohort trial in a tertiary paediatric anaesthesia centre
1Department of Paediatric Anaesthesiology and Intensive Care Medicine, University Hospital Brno, Faculty of Medicine, Masaryk University, Brno, Czech Republic
2 Faculty of Medicine, Masaryk University, Brno, Czech Republic
DOI: 10.22514/SV141.042018.10 Vol.14,Issue 1,March 2018 pp.59-62
Published: 27 March 2018
Background. Neuromuscular blockade is associated with improved airway condi-tions for intubation and superior condi-tions for surgical interventions (predomi-nantly important in laparoscopic surgery). Residual neuromuscular blockade in the postoperative period is, according to re-cently published data, associated with a negative impact on perioperative morbid-ity and mortality.
Aim. The aim of the study was to describe daily practice in clinical paediatric anaes-thesia in a tertiary children’s hospital. Methods. Data from anaesthesiology records during the period 1.1.2016 to 31.12.2016 were retrospectively screened. Primary outcomes included the rate of surgery cases with neuromuscular block-ade, the incidence of cases with periop-erative neuromuscular blockade monitor-ing and the incidence of neuromuscular pharmacologic block reversal. Secondary outcomes were myorelaxant usage accord-ing to the age of patients and duration of surgery.
Results. Overall 8046 paediatric patients underwent general anaesthesia in the study period. Muscle relaxants were adminis-tered in 1650 cases (20.5%). The most fre-quently administered muscle relaxant was mivacurium (48.2 %, n=795), followed by cis-atracurium (36.4 %, n=601), suxame-thonium (10.3 %, n=170) and rocuronium (7.0 %, n=115). Neuromuscular blockade monitoring was used only in 2.5% (n=41) of cases. Active neuromuscular blockade reversal was administered in 5.8% (n=95) of cases.Conclusion. Neuromuscular blockade in paediatric anaesthesia was less frequent compared to adults. The low rate of neuro-muscular blockade monitoring in combi-nation with the low rate of active block re-versal can be considered dangerous due to the relatively high risk of potential residual postoperative blockade, that can negatively influence clinical outcome.
neuromuscular blocking agent, paediatric anaesthesia, residual blockade, neuromuscular blockade
JOZEF KLUČKA,MICHAELA ŤOUKALKOVÁ,IVO KŘIKAVA,ROMAN ŠTOUDEK,EVA KLABUSAYOVÁ,MÁRIA MORAVSKÁ,PETR ŠTOURAČ. Neuromuscular blockade in clinical practice in paediatric anaesthesia: retrospective cohort trial in a tertiary paediatric anaesthesia centre. Signa Vitae. 2018. 14(1);59-62.
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