Neuromuscular blockade is one of the cornerstones of general anaesthesia, used both to facilitate endotracheal intubation and to allow surgical manipulation.
However, the activity of intermediate-acting neuromuscular blocking agents could persist after patient arousal from anaesthesia. The partial impairment of muscular activity in the postoperative period can contribute to the development of postoperative pulmonary complications through different mechanisms—namely, impaired contraction of ventilatory muscles with atelectasis formation, inability to cough, and impaired swallowing.
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- Farhan H
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- McLean D
- Eikermann M
Residual paralysis: does it influence outcome after ambulatory surgery?.
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Pulmonary complications are common in patients undergoing high-risk surgery, are associated with increased morbidity and mortality, and can increase health-care costs.
The effects of neuromuscular blocking agent, reversal agents, and neuromuscular blockade monitoring on the development of postoperative pulmonary complications are uncertain and mainly based on registry-based retrospective studies.
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- McLean DJ
- Diaz-Gil D
- Farhan HN
- Ladha KS
- Kurth T
- Eikermann M
Dose-dependent association between intermediate-acting neuromuscular-blocking agents and postoperative respiratory complications.
- Crossref
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Unfortunately, the quality of evidence in this field is low.
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Article Info
Publication History
Published: September 14, 2018
Identification
DOI: //doi.org/10.1016/S2213-2600(18)30363-1
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© 2018 Elsevier Ltd. All rights reserved.
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- Post-anaesthesia pulmonary complications after use of muscle relaxants
(POPULAR): a multicentre, prospective observational study
We showed that the use of neuromuscular blocking drugs in general anaesthesia is associated with an increased risk of postoperative pulmonary complications. Anaesthetists must balance the potential benefits of neuromuscular blockade against the increased risk of postoperative pulmonary complications.
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