The effect of postoperative residual paralysis on respiratory dysfunction

Abstract

Objective To determine the incidence of respiratory dysfunction aher general aneasthesia in postanesthesia care unit (PACU) and access its relationship with residual paralysis.Methods 623 adult patients,scheduled for elective surgical procedures,were enrolled in the study.On arrival to the PACU,the train-of-four ratio was assessed using electromyography.Fxtubation was determined using standard clinical criteria.Patients were divided into three groups according to the TOF measured after extubation,group A (TOF＞ 0.9); group B (TOF 0.7-0.9); group C (TOF＜0.7).The number of patients who have respiratory dysfunction were recorded in each group.Results The incidence of respiratory dysfunction after general aneasthesia in PACU is 4.5％.There were 7(1.6％),9(8.0％),and 12(30.8％) patients who had respiratory dysfunction in the groups A,B,C respectively.The most common complications are hypoxemia and airway obstruction.The incidence of respiratory insufficiency in the group C is significant higher than in the groups A and B,and it is significant higher in the group B than in the group A.Conclusions Patients with residual paralysis (TOF＜0.9) are more likely to have postoperative respiratory dysfunction and should be given neuromuscular monitoring perioperatively.The timing of extubation is very important. Key words: Non-depolarization neuromuscular blocking agents; Postoperative residual paralysis; Respiratory dysfunction