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1 - Comparison of residual curarization after extubation with clinical observation using either rocuronium or atracurium
Ayşe Hancı, G. Ulufer Sivrikaya, Birsen Ekşioğlu, Leyla T. Kılınç, Melahat K. Erol
Objective: In our study we aimed to compare the residual curarization after extubation with clinical observation using either rocuronium or atracurium which were antagonized with neostigmine.
Methods: Sixty patients in ASA I-II physical status undergoing abdominal hysterectomy operation were randomly assigned to two groups as: planned to apply rocuronium 0.6 mg.kg-1 to extubate with clinical observation (Group R); atracurium 0.5 mg.kg-1 to extubate with clinical observation (Group A). At the end of the operation all patients were antagonized with neostigmine. TOF values at extubation and at 1., 3., 5., 10. minutes after extubation, operation and anaesthesia times, total fentanyl, neuromuscular blocker agent and neostigmine doses were recorded.
Results: Demographic characteristics of the patients, duration of operation and anaesthesia, total fentanyl, neuromuscular blocker, neostigmine doses were similar in four groups. TOF ratio was <0.7 in all patients extubated according clinical observation at the extubation. TOF values were significantly lower in Group RK compared to Group RT at all intervals, in Group AK compared to Group AT at extubation, 1. and 3. minutes (p<0.05). Although TOF ratio was significantly lower in Group RK compared to Group AK at extubation (p<0.05), there were no significant differences at the other intervals. When all patients were considered, time to have TOF ratio ?0.7 and ?0.9 were 5.min and 10.min respectively in patients extubated according to clinical observation and time to have TOF ratio ?0.9 was 5.min in patients extubated with using TOF monitorization (p<0.05)
Conclusion: In our study we concluded TOF monitorization is a useful method in determination and prevention of residual curarrization and the incidence of residual block was found similar after administration of either rocuronium or atracurium after reversal with neostigmine.
Keywords: Neuromuscular block, monitoring, residual curarization, rocuronium, atracurium
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