Incidence of Residual Neuromuscular Blocking in Oncological Patients in the Anesthetic Rescue Room: Importance of Objective Monitoring in the Foundation Center of Control of Oncology of the State of Amazonas - Fcecon

Barros Fernanda Rondon Pirangy, Cardoso de Melo, Pimentel Ivandete Coelho Pereira, Ramos e Mewryane Câmara Brandão, Marques Jamilly Rebouças Demosthenes
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Abstract

The present research project aims to evaluate the incidence of residual neuromuscular block in the post-anesthetic recovery room in patients who underwent general anesthesia with mechanical ventilation. It is known that neuromuscular blockers are drugs that interrupt the transmission of nerve impulses at the neuromuscular junction causing muscle paralysis. In addition, they facilitate endotracheal intubation during anesthetic induction and allow for adequate surgical management. There are several adverse effects resulting from their use, among them: The occurrence of vagolytic and sympatholytic activities that cause cardiovascular alterations or autonomic stimulation. Monitoring the levels of these blockers is of paramount importance because it allows the titration of the drug. By relaxing and paralyzing the muscles, postoperative weakness due to the absence or incomplete performance of the antagonists of this drug is frequent. This situation is known as postoperative residual neuromuscular block. When it comes to the anesthetic practice to evaluate such situation, the patient’s clinic is often the only alternative. The safe use of neuromuscular blockers requires monitoring to qualify muscle relaxation by being measured from a known monitor of four stimuli or Train of Four (TOF). The residual neuromuscular blocker influences possible clinical complications that may lead to increased morbidity and mortality in the postoperative period. Thus, this project aims to identify the incidence of residual neuromuscular block in the postanesthetic recovery room in order to reduce the cardiorespiratory complications resulting from the use of the adenos polarizing neuromuscular blockers.
麻醉抢救室肿瘤患者残留神经肌肉阻滞发生率:亚马逊州肿瘤控制基金会中心客观监测的重要性
本研究项目旨在评估机械通气全身麻醉患者在麻醉后恢复室中残余神经肌肉阻滞的发生率。众所周知,神经肌肉阻滞剂是一种阻断神经肌肉接头处神经冲动传递的药物,可导致肌肉麻痹。此外,它们在麻醉诱导期间便于气管插管,并允许进行充分的手术管理。使用它们会产生一些不良影响,其中包括:迷走神经和交感神经活动的发生,导致心血管改变或自主神经刺激。监测这些阻断剂的水平至关重要,因为它可以对药物进行滴定。通过放松和麻痹肌肉,由于该药物拮抗剂的缺乏或不完全发挥而导致的术后虚弱是经常发生的。这种情况被称为术后残余神经肌肉阻滞。当涉及到麻醉实践来评估这种情况时,患者的诊所往往是唯一的选择。神经肌肉阻滞剂的安全使用需要通过已知的四种刺激监测器或TOF来进行监测,以确定肌肉放松。残留的神经肌肉阻滞剂会影响可能导致术后发病率和死亡率增加的临床并发症。因此,本项目旨在确定麻醉后恢复室中残留神经肌肉阻滞的发生率,以减少使用腺极化神经肌肉阻滞剂引起的心肺并发症。
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