Use of neuromuscular blocking agents in general anaesthesia for surgery: A three-month, single-centre study in a Czech regional hospital

Česká verze

Authors: Herold Ivan ¹; Sittová Naděžda ¹; Čurdová Marcela ¹; Adamus Milan ²
Authors place of work: Anesteziologicko-resuscitační oddělení, Oblastní nemocnice Mladá Boleslav, a. s. ¹; Klinika anesteziologie, resuscitace a intenzivní medicíny, Fakultní nemocnice a Lékařská fakulta Univerzity Palackého v Olomouci ²
Published in the journal: Anest. intenziv. Med., 23, 2012, č. 1, s. 6-13
Category: Anesteziologie - Původní práce

Summary

Objective:
Use of NMBAs in surgical anaesthesia.

Design:
Single-center, three-month analysis of anaesthesia charts (MBrelax2008).

Setting:
Department of Anaesthesiology and Intensive Care of a regional general hospital.

Materials and methods:
The observed parameters in surgical anaesthesia included the use of general anaesthesia (GA), regional anaesthesia (RA), suxamethonium and non-depolarising NMBAs. The results were compared to data from the observational one-day Czech Anesthesia Day (CAD2010).

Results:
Total 2316 anaesthesia charts from the observed period were evaluated. GA was used in 72.6 % (CAD2010 92.9 %, p < 0.0001). Orthopaedics/Trauma (366; 48.8 %), General Surgery (343; 80.3 %), Urology (248; 72.9 %), ENT (306; 100 %), Gynae/Obstetrics (406; 84.4 %) and Ophthalmology (12; 100 %). NMBAs were administered to 634 patients (37.7% vs 54.7% in CAD2010, p < 0.0001), most often in G/S (271; 79 %). LMA was inserted without facilitation by NMBAs in 478 (28.4 %) patients. Suxamethonium alone was used in 33 patients (2 % GA) only, most frequently in G/O. In the MBrelax2008 study, non-depolarizing NMBAs only were administered to 471 patients (28 % GA) vs. 684 (36.1% GA) in CAD2010 (p < 0.0001). Rocuronium was administered more often than cisatracurium (20.8 % vs. 13.8 %, p < 0.0001).

Conclusion:
Comparing with CAD2010, surgery was performed under GA less frequently, reflecting increasing preference of RA in the center. This correlates with the lower use of NMBAs. LMA were more often inserted without NMBAs. Rocuronium is the most frequently used NMBA. The results point to the difficulties experienced when comparing the data from observational multi-center studies with current clinical practice. The data should be evaluated for longer periods and comparable centers.

Keywords:
general anaesthesia – regional anaesthesia – pharmaco-economics – NMBA – suxamethonium – rocuronium – cisatracurium

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