Residual Curarization and Its Incidence at Tracheal Extubation in China
This is a prospective, multi-site, anesthesiologist and PACU nurse TOF-Watch SX® blinded
observational study of surgical patients undergoing elective laparoscopic or open abdominal
procedures requiring general anesthesia and non-depolarizing neuromuscular blockade. There
are two temporal aspects to the data collection: a prospective data collection in the OR and
PACU; and a retrospective chart review one week after hospital discharge.
Observational Model: Cohort, Time Perspective: Prospective
Percentage of Participants With Residual Neuromuscular Blockade (NMB)(Train of Four [TOF] Ratio <0.9) at Time of Tracheal Extubation
Neuromuscular functioning was monitored at time of tracheal extubation by applying three TOF electrical stimulations to the ulnar nerve and assessing twitch response at the adductor pollices muscle. T1 and T4 refer to the magnitudes (height) of the first and fourth twitches, respectively, after TOF nerve stimulation. The T4/T1 Ratio (expressed as a decimal of up to 1.0) indicates the extent of recovery from NMB, with a higher ratio indicating greater recovery from NMB. A T4/T1 Ratio of <0.9 is indicative of residual NMB.
Immediately prior to tracheal extubation in the OR
Xinmin Wu, MD
Peking University First Hospital
China: Food and Drug Administration