The Influence of Patient Controlled Analgesia on the Recovery of Muscle Power and Respiratory Function following Intraoperative Muscle Relaxants.
10.4097/kjae.2006.51.2.167
- Author:
Se Hwan KIM
1
;
Ok Sik HAN
;
Hee Soong JUNG
;
Doo Sik KIM
;
Sie Jeong RYU
;
Tae Ho CHANG
;
Kyung Han KIM
Author Information
1. Department of Anesthesiology and Pain Medicine, Kosin Medical College, Busan, Korea. kshwan@ns.kosinmed.or.kr
- Publication Type:Original Article
- Keywords:
head-lift test;
muscle relaxant;
patient-controlled analgesia;
SpO2;
TOF ratio;
tongue protrusion test
- MeSH:
Analgesia, Patient-Controlled*;
Analgesics, Opioid;
Anesthesia;
Anesthesia, Inhalation;
Atracurium;
Glycopyrrolate;
Humans;
Incidence;
Intubation;
Neuromuscular Blockade;
Paralysis;
Passive Cutaneous Anaphylaxis;
Pyridostigmine Bromide;
Recovery Room;
Relaxation;
Respiratory Insufficiency;
Tongue
- From:Korean Journal of Anesthesiology
2006;51(2):167-173
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Residual muscle paralysis after anesthesia is reduced with the advent of intermediate-acting neuromuscular blocking drugs, yet the incidence is as high as about 10 percent. Opioids in patient-controlled analgesia (PCA) may cause respiratory depression and other problems after anesthesia. The purpose of this study is to evaluate the influence of PCA on the SPO2, TOF ratio, head-lift and tongue protrusion during recovery room stay following intraoperative muscle relaxants. METHODS: 120 patients aged from 20 to 65 in ASA class I and II were divided into control or PCA groups. All patients received rocuronium (0.9 mg/kg) or atracurium (0.5 mg/kg) for tracheal intubation, and maintenance of relaxation was done with atracurium 0.2 mg/kg/hr during inhalation anesthesia. Reversal of block was done with pyridostigmine 0.15 mg/kg and glycopyrrolate 0.2 mg. SpO2, TOF ratio, 5 sec-head lift, tongue protrusion tests were evaluated in the recovery room. RESULTS: IV-PCA did not influence the incidence of residual block, SPO2, TOF ratio during recovery room stay for 20 minutes, but influenced negatively 5 sec-head lift test, tongue protrusion test only immediately after arrival at the recovery room. CONCLUSIONS: Since IV-PCA decreased the ability to perform head-lift and tongue protrusion early postoperatively, it is recommended that patients with IV-PCA should be carefully managed against the risk of aspiration or upper respiratory obstruction during their early recovery room stay.
