Locks Giovani de Figueiredo, Cavalcanti Ismar Lima, Duarte Nadia Maria Conceição, da Cunha Rafael Martins, de Almeida Maria Cristina Simões
Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil.
Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil.
Braz J Anesthesiol. 2015 Sep-Oct;65(5):319-25. doi: 10.1016/j.bjane.2015.03.001. Epub 2015 Aug 15.
The objective of this study was to evaluate how Brazilian anesthesiologists are using neuromuscular blockers, focusing on how they establish the diagnosis of postoperative residual curarization and the incidence of complications associated with the use of neuromuscular blockers. A questionnaire was sent to anesthesiologists inviting them to participate in the study. The online data collection remained open from March 2012 to June 2013. During the study period, 1296 responses were collected. Rocuronium, atracurium, and cisatracurium were the main neuromuscular blockers used in cases of elective surgery. Succinylcholine and rocuronium were the main neuromuscular blockers used in cases of emergency surgery. Less than 15% of anesthesiologists reported the frequent use of neuromuscular function monitors. Only 18% of those involved in the study reported that all workplaces have such a monitor. Most respondents reported using only the clinical criteria to assess whether the patient is recovered from the muscle relaxant. Most respondents also reported always using some form of neuromuscular blockade reversal. The major complications attributed to neuromuscular blockers were residual curarization and prolonged blockade. Eighteen anesthesiologists reported death attributed to neuromuscular blockers. Residual or prolonged blockade is possibly recorded as a result of the high rate of using clinical criteria to diagnose whether the patient has recovered or not from motor block and, as a corollary, the poor use of neuromuscular transmission monitors in daily practice.
本研究的目的是评估巴西麻醉医生如何使用神经肌肉阻滞剂，重点关注他们如何确立术后残余肌松的诊断以及与神经肌肉阻滞剂使用相关的并发症发生率。向麻醉医生发送了一份问卷，邀请他们参与研究。在线数据收集从2012年3月持续至2013年6月。在研究期间，共收集到1296份回复。罗库溴铵、阿曲库铵和顺式阿曲库铵是择期手术中使用的主要神经肌肉阻滞剂。琥珀酰胆碱和罗库溴铵是急诊手术中使用的主要神经肌肉阻滞剂。不到15%的麻醉医生报告经常使用神经肌肉功能监测仪。参与研究的人中只有18%报告所有工作场所都有这种监测仪。大多数受访者报告仅使用临床标准来评估患者是否已从肌肉松弛状态恢复。大多数受访者还报告总是使用某种形式的神经肌肉阻滞逆转。归因于神经肌肉阻滞剂的主要并发症是残余肌松和阻滞时间延长。18名麻醉医生报告有因神经肌肉阻滞剂导致的死亡。由于使用临床标准诊断患者是否已从运动阻滞中恢复的比例很高，以及相应地在日常实践中神经肌肉传递监测仪使用不佳，残余或延长的阻滞可能被记录下来。
