Forty years of neuromuscular monitoring and postoperative residual curarisation: a meta-analysis and evaluation of confidence in network meta-analysis

British Journal of Anaesthesia
Hugo CarvalhoJan Poelaert

Abstract

The reported incidence of postoperative residual curarisation (PORC) is still unacceptably high. The capacity of intraoperative neuromuscular monitoring (NMM) to reduce the incidence of PORC has yet to be established from pooled clinical studies. We conducted a meta-analysis of data from 1979 to 2019 to reanalyse this relationship. English language, peer-reviewed, and operation room adult anaesthesia setting articles published between 1979 and 2019 were searched for on PubMed, Cochrane Central Register of Controlled Trials, ISI-WoK, and Scopus. The primary outcome was PORC incidence as defined by an at- or post-extubation train-of-four ratio (TOFR) of lower than 0.7, 0.9, or 1.0. Additional collected variables included the duration of action of neuromuscular blocking agents (NMBAs) used, sugammadex or neostigmine use, and the technique of anaesthesia maintenance. Fifty-three studies (109 study arms, 12 664 patients) were included. The pooled PORC incidence associated with the use of intermediate duration NMBAs and quantitative NMM was 0.115 (95% confidence interval [CI], 0.057-0.188). This was significantly lower than the PORC rate for both qualitative NMM (0.306; 95% CI, 0.09-0.411) and no NMM (0.331; 95% CI, 0.234-0.435). Ana...Continue Reading

References

Jun 1, 1979·Anesthesiology·J Viby-MogensenH Ording
Mar 1, 1991·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·S J BrullD G Silverman
Feb 1, 1988·Acta Anaesthesiologica Scandinavica·B N AndersenB Juhl
Feb 1, 1989·Acta Anaesthesiologica Scandinavica·P Howardy-HansenB N Jensen
Feb 1, 1986·Anaesthesia and Intensive Care·G H Beemer, P Rozental
Jun 1, 1984·Acta Anaesthesiologica Scandinavica·C Lennmarken, J B Löfström
Aug 1, 1995·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·G D ShortenT Sieber
Oct 6, 1997·BMJ : British Medical Journal·M EggerC Minder
May 4, 2000·British Journal of Anaesthesia·C BaillardM Cupa
Apr 12, 2002·Acta Anaesthesiologica Scandinavica·M R GätkeL T Skovgaard
May 10, 2002·European Journal of Anaesthesiology·G CammuE Mortier
May 28, 2005·Anesthesia and Analgesia·Glenn S MurphyJeffery S Vender
Sep 27, 2005·British Journal of Anaesthesia·C BaillardC M Samama
Jan 26, 2006·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Guillaume TragerThomas M Hemmerling
Feb 20, 2007·British Journal of Anaesthesia·M NaguibJ E Ensor
Jul 10, 2007·British Journal of Anaesthesia·J Viby-MogensenL I Eriksson
Jul 19, 2008·Anesthesia and Analgesia·Glenn S MurphyJeffery S Vender
Nov 17, 2009·Anesthesia and Analgesia·Mohamed NaguibSorin J Brull
Oct 20, 2011·BMJ : British Medical Journal·Julian P T HigginsUNKNOWN Cochrane Statistical Methods Group
Sep 25, 2012·Anesthesiology·Stephan R ThilenSanjay M Bhananker
Oct 24, 2012·Anesthesiology·Gopalaiah Venkatesh KumarGundappa Parameshwara
Jun 13, 2013·Anesthesia and Analgesia·Yoshifumi KotakeJunzo Takeda
Jul 24, 2013·Anaesthesiology Intensive Therapy·Piotr Pietraszewski, Tomasz Gaszyński
Jul 6, 2014·PloS One·Georgia SalantiJulian P T Higgins
Nov 2, 2014·Behavior Research Methods·Wim Van den NoortgateJulio Sánchez-Meca
Jul 15, 2015·Journal of Clinical Monitoring and Computing·Jarno SalminenArvi Yli-Hankala
Oct 9, 2015·Anesthesiology·Glenn S MurphyAashka Patel

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Citations

Jan 3, 2021·Journal of Clinical Monitoring and Computing·Hugo CarvalhoJan Poelaert
Feb 1, 2021·British Journal of Anaesthesia·William J FawcettMichael J Scott
Jun 22, 2021·Journal of Medical Internet Research·Michaël VerdonckJan Poelaert
Jul 30, 2021·Anaesthesia·G RodneyUNKNOWN Working Party of the Association of Anaesthetists
Aug 17, 2021·Anesthesiology Clinics·Stephan R Thilen, Wade A Weigel

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