Variabilidad del bloqueo neuromuscular en pacientes con trauma, sometidos a cirugía de los hospitales Vicente Corral Moscoso y José Carrasco Arteaga, Cuenca – 2018

Abstract

Background: Neuromuscular blockers are frequently used in anesthesiology and their action may vary, depending on the patient’s characteristics, especially if they have hemodynamic instability.

Objective: To determine the variability of the relaxation time in the neuromuscular blockade of trauma patients undergoing surgery at the Vicente Corral Moscoso and José Carrasco Arteaga Hospitals.

Methodology: Descriptive, observational study in 105 trauma patients, under neuromuscular blockade, who met inclusion / exclusion criteria and were consecutively choosen. Neuromuscular relaxation was quantified by TOF-Watch; determining the onset of action time, onset of recovery, clinical duration, final TOF, incidence of residual blockade and association of the pathophysiological state, severity of the trauma and surgical time with the final TOF, using a value of p<0.05.

Results: This study showed a moderate trauma predominance (43.8%), male gender (75.2%) and ages between 20-40 years (53.3%); being the most common the skull and face trauma (37.1%); the residual block incidence was 26.7%, the action start time was 109.23 ± 20.50s; the onset of recovery was 24.29 ± 6,180m and the clinical duration 62.71 ± 21.00m; the severity of the trauma and the pathophysiological alteration were related to a final TOF <0.9 (p<0.05).

Conclusions: Trauma patients have an incidence of residual blockade and a variability of neuromuscular relaxation time in the ranges described in the literature. Severe trauma or any pathophysiological alteration upon admission increases the risk of residual neuromuscular paralysis and prolongation of the onset time of the relaxant action.