Safety of Intraoperative Use of Muscle Relaxants and Their Reversal Agent Neostigmine
| Status: | Active, not recruiting |
|---|---|
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 4/21/2016 |
| Start Date: | April 2011 |
| End Date: | December 2016 |
Consequences on Respiratory Morbidity and Health-care Utilization of Partial Paralysis Upon Admission to the Postanesthesia Care.
The investigators evaluate the assumption that postoperative residual curarization is
associated with impaired gas exchange upon post anesthesia care unit arrival and longer
hospital length of stay. Additionally, the investigators also evaluate the assumption the
use of neostigmine reversal of residual neuromuscular block is associated with an increased
incidence of postoperative pulmonary complications and intensive care unit admission.
associated with impaired gas exchange upon post anesthesia care unit arrival and longer
hospital length of stay. Additionally, the investigators also evaluate the assumption the
use of neostigmine reversal of residual neuromuscular block is associated with an increased
incidence of postoperative pulmonary complications and intensive care unit admission.
The investigators' laboratory has recently identified the intraoperative use of
intermediate-acting non-depolarizing neuromuscular blocking agents and neostigmine reversal
of neuromuscular blockade as independent risk factors for severe postoperative respiratory
complications. Additionally, the investigators found that postoperative residual
curarization (PORC), defined as a train-of-four ratio less than 0.90 upon postanesthesia
care unit (PACU) arrival, is associated with an increased PACU length of stay.
To examine the mechanisms contributing to the association of neuromuscular transmission
failure with postoperative respiratory complications, the investigators aim to evaluate in a
performance improvement driven initiative to better understand the association between the
use of neuromuscular blocking agents and reversal agents with postoperative respiratory
complications (see British Medical Journal 2012 Oct 15;345:e6329) if patients presenting
with PORC develop subsequently 1) an increased incidence of postoperative impaired gas
exchange upon PACU admission and result in 2) an increased hospital length of stay. In
addition the investigators evaluated the effects of neostigmine on signs and symptoms of
postoperative respiratory dysfunction and an incidence of unplanned postoperative intensive
care unit admission.
intermediate-acting non-depolarizing neuromuscular blocking agents and neostigmine reversal
of neuromuscular blockade as independent risk factors for severe postoperative respiratory
complications. Additionally, the investigators found that postoperative residual
curarization (PORC), defined as a train-of-four ratio less than 0.90 upon postanesthesia
care unit (PACU) arrival, is associated with an increased PACU length of stay.
To examine the mechanisms contributing to the association of neuromuscular transmission
failure with postoperative respiratory complications, the investigators aim to evaluate in a
performance improvement driven initiative to better understand the association between the
use of neuromuscular blocking agents and reversal agents with postoperative respiratory
complications (see British Medical Journal 2012 Oct 15;345:e6329) if patients presenting
with PORC develop subsequently 1) an increased incidence of postoperative impaired gas
exchange upon PACU admission and result in 2) an increased hospital length of stay. In
addition the investigators evaluated the effects of neostigmine on signs and symptoms of
postoperative respiratory dysfunction and an incidence of unplanned postoperative intensive
care unit admission.
Inclusion Criteria:
- Each subject has been given non-depolarizing neuromuscular blocking agents as part of
general anesthesia.
- Each subject must be at least 18 years of age
Exclusion Criteria:
- The subject is scheduled to be transferred to an intensive care unit after surgery.
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