Murphy Glenn S, Brull Sorin J
From Chicago, Illinois.
Mayo Clinic College of Medicine and Science, Jacksonville, Florida.
Anesthesiology. 2022 Feb 1;136(2):345-361. doi: 10.1097/ALN.0000000000004044.
Over the past five decades, quantitative neuromuscular monitoring devices have been used to examine the incidence of postoperative residual neuromuscular block in international clinical practices, and to determine their role in reducing the risk of residual neuromuscular block and associated adverse clinical outcomes. Several clinical trials and a recent meta-analysis have documented that the intraoperative application of quantitative monitoring significantly reduces the risk of residual neuromuscular blockade in the operating room and postanesthesia care unit. In addition, emerging data show that quantitative monitoring minimizes the risk of adverse clinical events, such as unplanned postoperative reintubations, hypoxemia, and postoperative episodes of airway obstruction associated with incomplete neuromuscular recovery, and may improve postoperative respiratory outcomes. Several international anesthesia societies have recommended that quantitative monitoring be performed whenever a neuromuscular blocking agent is administered. Therefore, a comprehensive review of the literature was performed to determine the potential benefits of quantitative monitoring in the perioperative setting.
在过去的五十年里,定量神经肌肉监测设备已被用于国际临床实践中检查术后残余神经肌肉阻滞的发生率,并确定其在降低残余神经肌肉阻滞风险及相关不良临床结局中的作用。多项临床试验和最近的一项荟萃分析表明,术中应用定量监测可显著降低手术室和麻醉后护理单元中残余神经肌肉阻滞的风险。此外,新出现的数据表明,定量监测可将不良临床事件的风险降至最低,如计划外的术后再次插管、低氧血症以及与神经肌肉恢复不完全相关的术后气道梗阻发作,并可能改善术后呼吸结局。几个国际麻醉学会建议,每当使用神经肌肉阻滞剂时,都应进行定量监测。因此,我们对文献进行了全面回顾,以确定定量监测在围手术期的潜在益处。