Paediatric Anaesthesiology
348
Neuromuscular blockade in clinical practice in
tertiary paediatric anaesthesia centre:
retrospective observational trial
Anaesthesia,paediatric, Anaesthesia,audit, Muscle skeletal,relaxation
J. Klucka1, P. Stourac1, M. Toukalkova1, R. Stoudek1, M. Moravska2, E. Klabusayova2
1Department of Paediatric Anesthesia and Intensive Care, University hospital and Faculty of
Medicine, Masaryk University - Brno (Czech Republic), 2Faculty of Medicine, Masaryk University -
Brno (Czech Republic)
Background and Goal of Study:Neuromuscular blockade is associated with improved airway conditions
for intubation and superior conditions for surgical interventions. Residual neuromuscular blockade in
postoperative period is, according to the recently published data, associated with the negative impact on
perioperative morbidity and mortality. The primary outcome was to evaluate the frequency of
neuromuscular blockade monitoring and the incidence of the active pharmacological block reversal at the
end of the operation. Secondary outcome was the frequency of the different muscle relaxants usage
according to the age of the patients and to the duration of the surgery.
Materials and Methods:After local Ethics Comittee approval and trial registeration on www.clinicaltrials.gov
(NCT03086915), all paediatric patients who underwent general anaesthesia between 1. 1. 2016 and 1. 12.
2016 were retrospectively screened. The methods of descriptive statistics (incidence, mean, median) were
used for study group data. Kruskal-Wallis H test was used to analyse the statistical significance by using
the median values and Chi-squared test by using the average values (Table 1, 2).
Results and Discussion:Overall 8046 paediatric patients underwent general anaesthesia in the study
period. Muscle relaxants were administered in 1650 cases (20.5%). Neuromuscular blockade monitoring
was used in 2.5% (n=41) cases. Active neuromuscular blockade reversal was administered in 5.8% (n=95)
cases, more frequently in older children (Table 1) and more frequently in block induced by rokuronium
(27.8%) (Table 2).The most frequently administered muscle relaxant was mivacurium (48.2 %, n=795),
followed by cis-atracurium (36.4 %, n=601), suxamethonium (10.3 %, n=170) and rocuronium (7.0 %,
n=115).
Conclusion(s):The low rate of neuromuscular blockade monitoring in combination with low rate of active
block reversal can be considered dangerous due to the relatively high risk of potential residual
postoperative blockade, that can negatively influence the clinical outcome.
05/12/2017 2/2
Funding: support by Internal grant agency Faculty of medicine MUNI/A/1161/2016 Czech Republic.

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