Recovery and prediction of postoperative muscle power – is it still a problem?

BMC Anesthesiology

Research Article

Hinnerk Wulf¹  Thomas Wiesmann¹  Dennis Kornmann¹  Benjamin Vojnar¹  Thomas Kratz²  Martin Zoremba³  Rene Burchard⁴ 

[1] Department of Anaesthesia and Intensive Care Medicine, University of Marburg, Baldinger Strasse, D-35033, Marburg, Germany;Department of Anaesthesia and Intensive Care Medicine, University of Marburg, Baldinger Strasse, D-35033, Marburg, Germany;Department of Anaesthesia and Intensive Care Medicine, Clinique Bénigne Joly, 4 Allée Roger Renard, F-21240, Talant, France;Department of Anaesthesia and Intensive Care Medicine, University of Marburg, Baldinger Strasse, D-35033, Marburg, Germany;Department of Anaesthesia, Intensive Care Medicine and Pain therapy, Kreisklinikum, Weidenauerstrasse 76, D-57076, Siegen, Germany;Department of Anaesthesia, Intensive Care Medicine and Pain therapy, Kreisklinikum, Weidenauerstrasse 76, D-57076, Siegen, Germany;

关键词: Muscle power;    Nmba;    Pulse oximetric saturation;   

DOI  :  10.1186/s12871-017-0402-7

 received in 2017-01-03, accepted in 2017-08-14,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundIn the postoperative period, immediate recovery of muscular power is essential for patient safety, but this can be affected by anaesthetic drugs, opioids and neuromuscular blocking agents (NMBA). In this cohort study, we evaluated anaesthetic and patient-related factors contributing to reduced postoperative muscle power and pulse oximetric saturation.MethodsWe prospectively observed 615 patients scheduled for minor surgery. Premedication, general anaesthesia and respiratory settings were standardized according to standard operating procedures (SOP). If NMBAs were administered, neuromuscular monitoring was applied to establish a Train of four (TOF)-Ratio of >0.9 before extubation. After achieving a modified fast track score > 10 at 4 time points up to 2 h postoperatively, we measured pulse oximetric saturation and also static and dynamic muscle power, using a high precision digital force gauge. Loss of muscle power in relation to the individual preoperative baseline value was analysed in relation to patient and anaesthesia-related factors using the T-test, simple and multiple stepwise regression analysis.ResultsDespite having achieved a TOF ratio of >0.9 a decrease in postoperative muscle power was detectable in most patients and correlated with reduced postoperative pulse oximetric saturation. Independent contributing factors were use of neuromuscular blocking agents (p < 0.001), female gender (p = 0.001), TIVA (p = 0.018) and duration of anaesthesia >120 min (p = 0.019).ConclusionSignificant loss of muscle power and reduced pulse oximetric saturation are often present despite a TOF-Ratio > 0.9. Gender differences are also significant. A modified fast track score > 10 failed to predict recovery of muscle power in most patients.Trial registrationGerman Clinical Trial Register DRKS-ID DRKS00006032; Registered: 2014/04/03

【 授权许可】

CC BY   
© The Author(s). 2017