Effect of quantitative versus qualitative neuromuscular blockade monitoring on rocuronium consumption in patients undergoing abdominal and gynecological surgery: a retrospective cohort study

This study aims to compare the dosage of the neuromuscular blocking agents (NMBA) rocuronium and the need for reversion by sugammadex between those methods. A retrospective, observational analysis was conducted. In the tactile qualitative-neuromuscular monitoring-group (tactile NMM) (n ā€‰=ā€‰244), muscle contractions were assessed tactilely. In the quantitative neuromuscular monitoring-group (nā€‰=ā€‰295), contractions were accessed using an acceleromyograph. Primary endpoints were dosage of rocuronium per minute operation-time (milligram per kilogram bodyweight per minute (mg/kg BW/min)), count of repeated rocuronium administrations and use of sugammadex. Secondary endpoints were: NMM use before repeated NMBA application or extubation, time to extubation, post-operative oxygen demand. A total of nā€‰=ā€‰539 patients were included. nā€‰=ā€‰244 patients were examined with tac tile NMM and 295 patients by quantitative NMM. Quantitative NMM use resulted in significantly lower rocuronium dosing (tactile NMM: 0.01 (Ā±ā€‰0.007) mg/kgBW/min vs. quantitative NMM: 0.008 (Ā±ā€‰0.006) mg/kgBW/min (pā€‰< ā€‰0.001)). In quantitative NMM use fewer repetitions of rocuronium application were necessary (tactile NMM: 83% (nā€‰=ā€‰202) vs. quantitative NMM: 71% (nā€‰=ā€‰208)pā€‰=ā€‰0.007). Overall, 24% (nā€‰=ā€‰58) in the tactile NMM-group, and 20% (nā€‰=ā€‰60) in the quantitative NMM-group received sugammadex ((pā€‰=ā€‰0.3), OR: 1.21 (0.81ā€“1.82)). Significantly fewer patients in the quan...
Source: Journal of Clinical Monitoring and Computing - Category: Information Technology Source Type: research