Partial curarization in the postoperative period

Abstract

Forty-eight patients subjected to elective surgery were randomly selected for evaluation of neuromuscular transmission in the postoperative period. All patients were anaesthetized with thiopentone, nitrous oxide, fentanyl and pancuronium. On arrival in the postoperative ward, alertness, ability to sustain head lift and the train-of-four (TOF) ratio were estimated. Twenty-five percent of the patients had a markedly impaired neuromuscular transmission which was not acceptable from a clinical standpoint. The given dose of pancuronium was not excessively high and a fairly long time had elapsed between reversal and TOF-ratio measurement. There was a poor correlation between TOF ratio and ability to sustain head lift. The study indicates that residual curarization is a not uncommon fact which clinically is hard to assess. The only wat to avoid residual curarization seems to be to monitor the neuromuscular transmission during anaesthesia.