General anaesthesia and neuromuscular blockade techniques in a regional and university hospitals– a three-month bicentric observational study


Authors: Adamus Milan 1,2;  Herold Ivan 3;  Částková Adéla 1;  Obare Pyszková Lenka 1;  Reichelová Denisa 1;  Nováček Jiří 3;  Sittová Naděžda 3;  Čurdová Marcela 3;  Hrabálek Lumír 2,4
Authors‘ workplace: Klinika anesteziologie, resuscitace a intenzivní medicíny, Fakultní nemocnice Olomouc 1;  Lékařská fakulta Univerzity Palackého v Olomouci 2;  Anesteziologicko-resuscitační oddělení, Oblastní nemocnice Mladá Boleslav, a. s. 3;  Neurochirurgická klinika, Fakultní nemocnice Olomouc 4
Published in: Anest. intenziv. Med., 24, 2013, č. 5, s. 311-320
Category: Anaesthesiology - Original Paper

Overview

Objective:
Comparison of general anaesthesia techniques focused on neuromuscular blockade in a regional and university hospitals.

Design:
Retrospective study, three-month analysis of anaesthesia charts.

Setting:
Departments of Anaesthesiology and Intensive Therapy of a regional and university hospitals.

Materials and methods:
Anaesthetic charts for all anae-stetic procedures performed in a regional (MB2011) and university (FNOL2011) hospitals during a 3-month period (September- November 2011) were analysed, focusing on patients‘ demographic data, type and lenght of anaesthesia, airway maintainance, neuromuscular blockade, techniques of block reversal and monitoring. The data were compared between the hospitals (unpaired t-test, Fisher exact, Chi-squared test) with statistical significance p < 0.05.

Results:
The total number of anaesthetic procedures performed in MB2011 was 2886, in FNOL2011 4746. General anaesthesia was more frequent in FNOL2011 (92.5%) than in MB2011 (55.5%, p < 0.0001), where 27.3% of procedures were performed in regional anaesthesia (alone or supplemented with analgosedation). Procedures lasting less than 60 minutes were more frequent in MB2011 (69.2%), whereas in FNOL2011 procedures lasting over 60 minutes prevailed (64.7%). LMA was used more often in MB2011 (26.5%) than in FNOL2011 (14.2%, p < 0.0001) for airway maintenance. Neuromuscular blockade was utilised more often in FNOL2011 (61.7%) than in MB2011 (41.5%, p < 0.0001). Rocuronium was the most frequently used NMBA (MB2011 88.5%, FNOL 75.5%, p < 0.0001). Depth of blockade was monitored in 52.1% patients in MB2011, compared to 8.5% patients in FNOL2011, p < 0.0001). Neuromuscular blockade was reversed with neostigmine in 89.8% patients (MB2011) vs. 18.3% (FNOL2011, p < 0.0001), with mean dose of 0.024 ± 0.007 mg/kg (MB2011) vs. 0.019 ± 0.025 mg/kg (FNOL2011, p < 0.0001).

Conclusion:
We observed differences in anaesthesia care procedures between a regional and university hospitals.

Keywords:
general anaesthesia – airway – neuromuscular blockade – reversal – monitoring


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Anaesthesiology, Resuscitation and Inten Intensive Care Medicine

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