The urgency of the problem of residual neuromuscular block after single intraoperative relaxant administration in neurosurgical patients: preliminary data
Under the present-day conditions, it is necessary to allow for rapid postoperative awakening in each neurosurgical patient, which is impossible under residual neuromuscular block. The paper gives the preliminary data of a prospective observational study of the frequency of residual neuromuscular block after single intraoperative administration of a moderate- or long-acting myorelaxant. When the myorelaxants are used once according to the standard procedure (in the absence of TOF monitoring and pharmacological elimination of the action of myorelaxants), the rate of residual myorelaxation in neurosurgical patients has been found to be unacceptably high and to hinder their rapid awakening and neurological assessment. The administration of pipecuronium gives rise to residual block in all cases. That of rocuronium makes it possible to reduce the rate of residual myorelaxation, but not to eliminate it completely. Residual block can be preserved 2-4.5 hours after single administration of rocuronium or pipecuronium.