Perioperative neuromuscular blockade. 2020 update of the SEDAR (Sociedad Española de Anestesiología y Reanimación) recommendations.

Autor: Díaz-Cambronero O; Hospital Universitari Politécnic La Fe, Grupo de Investigación Medicina Perioperatoria, Instituto de Investigación Sanitaria La Fe, Valencia, Spain. Electronic address: oscardiazcambronero@gmail.com., Serrano A; Hospital Ramón y Cajal, Madrid, Spain. Electronic address: anab.serrano@yahoo.es., Abad-Gurumeta A; Hospital Universitario Infanta Leonor, Madrid, Spain. Electronic address: alfredoabadgurumeta@gmail.com., Garutti Martinez I; Hospital Universitario Gregorio Marañón, Madrid, Spain. Electronic address: ngaruttimartinez@yahoo.es., Esteve N; Hospital Son Espases, Palma de Mallorca, Mallorca, Spain. Electronic address: neus.esteve@ssib.es., Alday E; Hospital de La Princesa, Madrid, Spain. Electronic address: kikealday@hotmail.com., Ferrando C; Hospital Clínic, Barcelona, Spain. Electronic address: cafeoranestesia@gmail.com., Mazzinari G; Hospital Universitari Politécnic La Fe, Grupo de Investigación Medicina Perioperatoria, Instituto de Investigación Sanitaria La Fe, Valencia, Spain. Electronic address: gmazzinari@gmail.com., Vila-Caral P; Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain. Electronic address: 17938pvc@gmail.com., Errando Oyonarte CL; Hospital Can Misses, Ibiza, Islas Baleares, Consorcio Hospital General Universitario de Valencia, Valencia, Spain. Electronic address: errando013@gmail.com.
Jazyk: angličtina
Zdroj: Revista espanola de anestesiologia y reanimacion [Rev Esp Anestesiol Reanim (Engl Ed)] 2023 Jan; Vol. 70 (1), pp. 37-50. Date of Electronic Publication: 2023 Jan 05.
DOI: 10.1016/j.redare.2022.02.005
Abstrakt: We present an update of the 2020 Recommendations on neuromuscular blockade of the SEDAR. The previous ones dated 2009. A modified Delphi consensus analysis (experts, working group, and previous extensive bibliographic revision) 10 recommendations were produced 1 : neuromuscular blocking agents were recommended for endotracheal intubation and to avoid faringo-laryngeal and tracheal lesions, including critical care patients. 2 We recommend not to use neuromuscular blocking agents for routine insertion of supraglotic airway devices, and to use it only in cases of airway obstruction or endotracheal intubation through the device. 3 We recommend to use a rapid action neuromuscular blocking agent with an hypnotic in rapid sequence induction of anesthesia. 4 We recommend profound neuromuscular block in laparoscopic surgery. 5 We recommend quantitative monitoring of neuromuscular blockade during the whole surgical procedure, provided neuromuscular blocking agents have been used. 6 We recommend quantitative monitoring through ulnar nerve stimulation and response evaluation of the adductor pollicis brevis, acceleromyography being the clinical standard. 7 We recommend a recovery of neuromuscular block of at least TOFr ≥ 0.9 to avoid postoperative residual neuromuscular blockade. 8 We recommend drug reversal of neuromuscular block at the end of general anesthetic, before extubation, provided a TOFr ≥ 0.9 has not been reached. 9 We recommend to choose anticholinesterases for neuromuscular block reversal only if TOF≥2 and a TOFr ≥ 0.9 has not been attained. 10 We recommend to choose sugammadex instead of anticholinesterases for reversal of neuromuscular blockade induced with rocuronium.
(Copyright © 2022 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
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