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Abstract：
NMB facilitates intubating conditions in general anesthesia. However, it is associated with significant residual postoperative paralysis and morbidity.
To investigate the rate of underdiagnosed residual NMB based on two TOFR criteria (< 0.91 and < 1.00).
We performed a retrospective study adhering to STROBE guidelines. We included patients undergoing ENT surgery using single-dose neuromuscular block for balanced general anesthesia from June to December 2018. We collected demographic and anthropometric data, ASA score, NMBA dose, TOFR recordings at 5, 30 and 60 min and end of the surgery, anesthesia and surgery time, and administration of reversal agent. Statistical analysis included descriptive and dispersion measures statistics, curve and cross tables for residual NMB on different TOFR criteria with sub-analysis for AR, RR, and OR in patients over 65 years old.
We included 57 patients, mean age 41; 43 females and 14 males. Mean anesthetic and surgical time were 139.4 and 116.1 min, respectively. All the patients received rocuronium under a mean ponderal single-dose of 0.48 mg/kg. Residual NMB rates were 29.9 and 49.1% for a TOFR < 0.91 and < 1.00, respectively. Older adults had an OR of 6.08 for residual NMB.
The rate of residual NMB was 29.9 to 49.1%, depending on the criteria used (TOFR < 0.91 and < 1.00, respectively). Patients above 65 years old had an increased risk of residual NMB (6.08 OR) and clinical symptoms related to residual NMB (11.75 OR). We recommend future research aiming to provide a specific surveillance protocol for patients above 65 years old, including shorter-action NMB, early reversal, and prolonged surveillance using the TOFR criteria of < 1.00 to identify patients at risk of residual NMB readily.
To investigate the rate of underdiagnosed residual NMB based on two TOFR criteria (< 0.91 and < 1.00).
We performed a retrospective study adhering to STROBE guidelines. We included patients undergoing ENT surgery using single-dose neuromuscular block for balanced general anesthesia from June to December 2018. We collected demographic and anthropometric data, ASA score, NMBA dose, TOFR recordings at 5, 30 and 60 min and end of the surgery, anesthesia and surgery time, and administration of reversal agent. Statistical analysis included descriptive and dispersion measures statistics, curve and cross tables for residual NMB on different TOFR criteria with sub-analysis for AR, RR, and OR in patients over 65 years old.
We included 57 patients, mean age 41; 43 females and 14 males. Mean anesthetic and surgical time were 139.4 and 116.1 min, respectively. All the patients received rocuronium under a mean ponderal single-dose of 0.48 mg/kg. Residual NMB rates were 29.9 and 49.1% for a TOFR < 0.91 and < 1.00, respectively. Older adults had an OR of 6.08 for residual NMB.
The rate of residual NMB was 29.9 to 49.1%, depending on the criteria used (TOFR < 0.91 and < 1.00, respectively). Patients above 65 years old had an increased risk of residual NMB (6.08 OR) and clinical symptoms related to residual NMB (11.75 OR). We recommend future research aiming to provide a specific surveillance protocol for patients above 65 years old, including shorter-action NMB, early reversal, and prolonged surveillance using the TOFR criteria of < 1.00 to identify patients at risk of residual NMB readily.
摘要：
背景：NMB有利于全身麻醉的插管条件。然而,它与显著的残余术后瘫痪和发病率相关。
目的：根据两个TOFR标准（<0.91和<1.00）调查未诊断的残留NMB的发生率。
方法：我们按照STROBE指南进行了一项回顾性研究。我们纳入了2018年6月至12月使用单剂量神经肌肉阻滞进行平衡全身麻醉的ENT手术患者。我们收集了人口统计和人体测量数据，ASA得分,NMBA剂量，在5、30和60分钟以及手术结束时记录TOFR，麻醉和手术时间，和逆转剂的管理。统计分析包括描述性和分散性测量统计，不同TOFR标准下残留NMB的曲线和交叉表，并对AR进行子分析，RR,和OR在65岁以上的患者中。
结果：我们包括57例患者，平均年龄41岁；43名女性和14名男性。平均麻醉和手术时间分别为139.4和116.1分钟，分别。所有患者均接受罗库溴铵的平均单剂量为0.48mg/kg。对于TOFR<0.91和<1.00,残余NMB率分别为29.9%和49.1%。老年人的残余NMB的OR为6.08。
结论：残留NMB率为29.9-49.1%，取决于使用的标准（TOFR分别<0.91和<1.00）。65岁以上患者的残余NMB（6.08OR）和与残余NMB相关的临床症状（11.75OR）的风险增加。我们建议未来的研究旨在为65岁以上的患者提供特定的监测方案，包括较短动作的NMB，早期逆转,和使用<1.00的TOFR标准进行长期监测，以确定有残留NMB风险的患者。
目的：根据两个TOFR标准（<0.91和<1.00）调查未诊断的残留NMB的发生率。
方法：我们按照STROBE指南进行了一项回顾性研究。我们纳入了2018年6月至12月使用单剂量神经肌肉阻滞进行平衡全身麻醉的ENT手术患者。我们收集了人口统计和人体测量数据，ASA得分,NMBA剂量，在5、30和60分钟以及手术结束时记录TOFR，麻醉和手术时间，和逆转剂的管理。统计分析包括描述性和分散性测量统计，不同TOFR标准下残留NMB的曲线和交叉表，并对AR进行子分析，RR,和OR在65岁以上的患者中。
结果：我们包括57例患者，平均年龄41岁；43名女性和14名男性。平均麻醉和手术时间分别为139.4和116.1分钟，分别。所有患者均接受罗库溴铵的平均单剂量为0.48mg/kg。对于TOFR<0.91和<1.00,残余NMB率分别为29.9%和49.1%。老年人的残余NMB的OR为6.08。
结论：残留NMB率为29.9-49.1%，取决于使用的标准（TOFR分别<0.91和<1.00）。65岁以上患者的残余NMB（6.08OR）和与残余NMB相关的临床症状（11.75OR）的风险增加。我们建议未来的研究旨在为65岁以上的患者提供特定的监测方案，包括较短动作的NMB，早期逆转,和使用<1.00的TOFR标准进行长期监测，以确定有残留NMB风险的患者。
