Abstract
Background. Neuromuscular blockade is associated with improved airway condi-tions for intubation and superior condi-tions for surgical interventions (predomi-nantly important in laparoscopic surgery). Residual neuromuscular blockade in the postoperative period is, according to re-cently published data, associated with a negative impact on perioperative morbid-ity and mortality. Aim. The aim of the study was to describe daily practice in clinical paediatric anaes-thesia in a tertiary children’s hospital. Methods. Data from anaesthesiology records during the period 1.1.2016 to 31.12.2016 were retrospectively screened. Primary outcomes included the rate of surgery cases with neuromuscular block-ade, the incidence of cases with periop-erative neuromuscular blockade monitor-ing and the incidence of neuromuscular pharmacologic block reversal. Secondary outcomes were myorelaxant usage accord-ing to the age of patients and duration of surgery. Results. Overall 8046 paediatric patients underwent general anaesthesia in the study period. Muscle relaxants were adminis-tered in 1650 cases (20.5%). The most fre-quently administered muscle relaxant was mivacurium (48.2 %, n=795), followed by cis-atracurium (36.4 %, n=601), suxame-thonium (10.3 %, n=170) and rocuronium (7.0 %, n=115). Neuromuscular blockade monitoring was used only in 2.5% (n=41) of cases. Active neuromuscular blockade reversal was administered in 5.8% (n=95) of cases.Conclusion. Neuromuscular blockade in paediatric anaesthesia was less frequent compared to adults. The low rate of neuro-muscular blockade monitoring in combi-nation with the low rate of active block re-versal can be considered dangerous due to the relatively high risk of potential residual postoperative blockade, that can negatively influence clinical outcome. 
Highlights
Neuromuscular blockade (NB) can be considered a standard part of general anaesthesia
Neuromuscular blockade in paediatric anaesthesia was less frequent compared to adults
All paediatric patients who underwent general anaesthesia at the Department of Paediatric Anaesthesiology and Intensive Care Medicine during the study period between 1. 1. 2016 and 1. 12. 2016, based on data derived from anaesthesiology records, were screened
Summary
Neuromuscular blockade (NB) can be considered a standard part of general anaesthesia. Clinical signs of recovery (squeezing of the hand, lifting the head and other signs) are not sufficiently sensitive compared to accelerometry [5] and require the patients active involvement, which can be difficult and is influenced by the age of the patient It seems, that the usage of NB in paediatric anaesthesia is lower (compared to adults), the incidence of active pharmacological reversal of blockade and the incidence of neuromuscular blockade monitoring remains unclear. The aim of this study was to describe the actual practice in a tertiary paediatric anaesthesiology centre – incidence of NB usage, incidence of monitoring the depth of blockade and possible RB at the end of surgery and incidence of active pharmacological reversal. Residual neuromuscular blockade in the postoperative period is, according to recently published data, associated with a negative impact on perioperative morbidity and mortality. Active neuromuscular blockade reversal was administered in 5.8% (n=95) of cases
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