Postoperative Residual Curarization in the Recovery Room after Vecuronium or Rocuronium Use

Lee, Jeong Seok; Han, Seung Yeup; Cho, Sung Hwan; Chung, Ji Weon; Kim, Sang Hyun; Chai, Won Seok; Jin, Hee Cheol; Kim, Yong Ik

Clinical Research

Neuromuscular Physiology and Pharmacology

Anesthesia and Pain Medicine 2006;1(2):101-105.
Published online October 30, 2006.

Postoperative Residual Curarization in the Recovery Room after Vecuronium or Rocuronium Use

Jeong Seok Lee, Seung Yeup Han, Sung Hwan Cho, Ji Weon Chung, Sang Hyun Kim, Won Seok Chai, Hee Cheol Jin, Yong Ik Kim

Department of Anesthesiology and Pain Medicine, Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea. juju1218@dreamwiz.com

Abstract

BACKGROUND
Postoperative residual curarization subsequent to the use of neuromuscular blocking drugs can cause respiratory problems. This study examined the incidence of postoperative residual curarization on the arrival of patients in the recovery room. METHODS: Two-hundred-fifty-nine patients were enrolled in the study. The neuromuscular blockade was maintained with vecuronium or rocuronium and all subjects were reversed with pyridostigmine. The train of four ratios (TR) was quantified by acceleromyography immediately upon their arrival in the recovery room. The residual curarization was defined as a TR of < 0.9. RESULTS: The incidence of residual curarization was 32.8% (84 patients). The time from the last dose of muscle relaxants to the TR assessment in the recovery room was significantly different between those with a TR <0.9 (74.9 +/- 35.3 min) and a TR > 0.9 (104.5 +/- 51.1 min) patients. The total dose of muscle relaxants corrected by the ED95 was significantly different between TR < 0.9 and TR > or = 0.9 patients. The total dose of vecuronium or rocuronium, and the dose of pyridostimine was similar in the TR < 0.9 and TR > or = 0.9 patients. CONCLUSIONS: Significant postoperative residual curarization waspresent in the majority of patients, even with the use of intermediate- acting neuromuscular blocking drugs. In addition, the time from the last dose of muscle relaxants to the TR assessment in the recovery room is a major factor that affects the residual curarization.

Key Words: residual curarization, rocuronium, vecuronium