The occurrence of postoperative residual curarization among post-coronary artery bypass graft patients in a surgical intensive care unit of a tertiary hospital
- Author:
Marion R. Nuevo
1
;
Florian R. Nuevo
1
Author Information
- Publication Type:Journal Article
- From: Philippine Journal of Cardiology 2021;49(1):50-56
- CountryPhilippines
- Language:English
-
Abstract:
BACKGROUND:Intermediate-acting muscle relaxants have gained favor in fast-track cardiac anesthesia since these are associated with early extubation. However, postoperative residual curarization (PORC) still occur in the post anesthesia care unit. This study aims to determine the occurrence of PORC among post coronary artery bypass graft (CABG) patients in the surgical intensive care units (SICU) of the Philippine Heart Center.
METHODS:A cross-sectional study was undertaken among 60 patients for elective CABG surgery. Within an hour from SICU arrival, Train of Four (TOF) ratio was obtained and a value of <0.7 signified the presence of PORC.
RESULTS:57 out of 60 (95%) were found to have PORC. Patients without PORC were significantly warmer (36.4o C vs 34.8o C, p-value=0.019) upon SICU arrival compared to those with PORC. The duration of ventilatory support was significantly longer in those with PORC (510 min vs 305 mins, p-value=0.021). The rocuronium induction dose and duration of infusion did not differ between those with and without PORC while the use of reversal drug was seen to significantly prevent its occurrence (p-value=0.003).
CONCLUSION:This study showed a high incidence of PORC among post-CABG patients in the SICU with the current practice of Rocuronium infusion during surgery. The use of muscle relaxant reversal drug was seen to significantly prevent the development of PORC while higher body temperature upon SICU arrival was observed in patients that did not develop PORC. This study was also able to show that the development of PORC prolonged post-operative mechanical ventilatory support hindering the goals of fast-track cardiac surgery. - Full text:202410181633511031150_PJC Jan Jun 2021.pdf
