Anest. intenziv. Med. 2011;22(2):82-89

Neuromuscular blockade during general anaesthesia in the Czech Republic 2010 - a one-day, prospective, observational surveyAnaesthesiology - Original Paper

Adamus Milan^1,*, Herold Ivan², Cvachovec Karel³, Ševčík Pavel⁴, Černý Vladimír^5,6

¹ Klinika anesteziologie a resuscitace, Lékařská fakulta Univerzity Palackého v Olomouci, Fakultní nemocnice Olomouc

² Anesteziologicko-resuscitační oddělení, Oblastní nemocnice Mladá Boleslav, a. s.

³ Klinika anesteziologie a resuscitace, Univerzita Karlova v Praze, 2. lékařská fakulta a IPVZ, Fakultní nemocnice Motol, Praha

⁴ Klinika anesteziologie, resuscitace a intenzivní medicíny, Lékařská fakulta Masarykovy univerzity Brno, Fakultní nemocnice Brno

⁵ Dalhousie University, Dept. of Anesthesia, Halifax, Nova Scotia, Canada

⁶ Klinika anesteziologie, resuscitace a intenzivní medicíny, Univerzita Karlova v Praze, Lékařská fakulta v Hradci Králové, Fakultní nemocnice Hradec Králové

Objective:
To obtain data about the use of neuromuscular blocking agents during general anaesthesia in the Czech Republic.

Design:
One-day, prevalence, questionnaire survey.


Setting:
All anaesthetic care providers that registered before the date of the study.

Materials and methods:
This survey was part of the Czech Anaesthesia Day 2010 study. All the patients whose anaesthetic care was provided by the registered anaesthetic departments and was commenced on June 1, 2010, from 7:00 to 24:00 were enrolled. Data of each patient were entered into a web-based questionnaire and information relevant to neuromuscular blockade was collected.

Results:
Total 2,252 patients were given general anaesthesia and neuromuscular blockade was used in 55.9% cases. Tracheal intubation for elective surgery was most often facilitated by a non-depolarizing agent (55.7%), and in emergency cases by suxamethonium (49.4%). Atracurium (43.1%), suxamethonium (31.2%) and rocuronium (24.4%) were the most frequently used agents. During day-case surgery, a neuromuscular blocking agent was used in 3% cases compared to 39.9% for in-patient surgery (p < 0.0001). To reverse the block, neostigmine was administered in 24.1% of patients and sugammadex was used in one patient.
The degree of the neuromuscular block was monitored in 5.1%. Patients with neuromuscular monitoring received neostigmine more often than those without monitoring.

Conclusion:
A neuromuscular blocking agent was used during the maintenance of more than 50% of the general anaesthesia cases; atracurium, suxamethonium and rocuronium were the most frequently used drugs. A reversal agent (neostigmine) was given to 24% patients. Monitoring of the block was rare (5%).

Keywords: questionnaire survey; general anaesthesia; neuromuscular block; non-depolarizing neuro-muscular blocking agent; suxamethonium; reversal; monitoring

Received: January 4, 2011; Accepted: February 3, 2011; Published: April 1, 2011  Show citation