Residual neuromuscular block

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As neuromuscular blockade radical , postoperative Restcurarisierung (PORC) or Relaxansüberhang refers to an undesirable residual effects of certain anesthetics ( muscle ) by the end of an operation . It increases the risk of post-operative complications from the lung.

The incomplete muscle function makes it difficult to cough up mucus and saliva, so that small amounts of pharyngeal mucus contaminated with bacteria can be swallowed unnoticed into the lungs (microaspiration). As a result of these microaspirations, inflammation of the bronchi or pneumonia usually only develops after a few days. It is estimated that an untreated relaxant overhang quadruples the risk of pneumonia after surgery.

PORC is observed more often after long-acting use than after medium-acting muscle relaxants. Some other drugs, such as inhalation and local anesthetics , corticosteroids , magnesium, and some antibiotics, cause prolonged neuromuscular blockade. In the period between 1995 and 2004, the use of quantitative measurement methods ( neuromuscular monitoring ) for PORC increased and the frequency of PORC itself decreased.

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  1. ↑ H. Berg, J. Viby-Mogensen, J. Roed, CR Mortensen, J. Engbaek, LT Skovgaard, JJ Krintel: Residual neuromuscular block is a risk factor for postoperative pulmonary complications A prospective, randomized, and blinded study of postoperative pulmonary complications after atracurium, vecuronium and pancuronium. In: Acta Anesthesiologica Scandinavica. 41, 1997, pp. 1095-1103, doi: 10.1111 / j.1399-6576.1997.tb04851.x .
  2. ^ M. Naguib, AF Kopman, JE Ensor: Neuromuscular monitoring and postoperative residual curarization: a meta-analysis. In: Br J Anaesth. (2007); 98, pp. 302-316. PMID 17307778 .
  3. ^ AS Milde, J. Motsch: drug interactions for the anesthetist. In: Anaesthesiologist. (2003); 52, pp. 839-859. Full text online (PDF; 383 kB), accessed on March 25, 2007.
  4. ↑ C. Baillard et al .: Postoperative residual neuromuscular block: a survey of management. In: Br J Anaesth. (2005); 95, pp. 622-626. PMID 16183681 .