[Deep neuromuscular blockade : Benefits and risks]

Anaesthesist. 2018 Mar;67(3):165-176. doi: 10.1007/s00101-018-0425-6.
[Article in German]

Abstract

Neuromuscular blockade (TOF count = 0) can improve tracheal intubation and microlaryngeal surgery. It is also frequently used in many surgical fields including both nonlaparoscopic and laparoscopic surgery to improve surgical conditions and to prevent sudden muscle contractions. Currently there is a controversy regarding the need and the clinical benefits of deep neuromuscular blockade for different surgical procedures. Deep neuromuscular relaxation improves laparoscopic surgical space conditions only marginally when using low intra-abdominal pressure. There is no outcome-relevant advantage of low compared to higher intra-abdominal pressures, but worsen the surgical conditions. Postoperative, residual curarisation can be avoided by algorithm-based pharmacological reversing and quantitative neuromuscular monitoring.

Keywords: Deep neuromuscular blockade; Operation conditions; Quantitative neuromuscular monitoring; Residual curarisation; Reversing.

Publication types

  • Review

MeSH terms

  • Humans
  • Intubation, Intratracheal
  • Laparoscopy / methods
  • Neuromuscular Blockade / methods*
  • Neuromuscular Monitoring
  • Surgical Procedures, Operative