The use of neuromuscular blockade in the departments of anaesthesia in the Czech Republic
in 2006 – a questionnaire survey
Adamus M.1, Gabrhelík T.1, Marek O.1, Koutná J.1, Trenkler Š.2
1Klinika anesteziologie a resuscitace, Fakultní nemocnice a Lékarská fakulta Univerzity Palackého, Olomouc 2Klinika anestéziológie a intenzívnej medicíny, Fakultná NsP Jána Adama Reimana, Prešovská univerzita a Slovenská zdravotnícka univerzita, Prešov, Slovenská republika |
|
Summary:
Objective: To evaluate the use of muscle relaxants in the anaesthetic departments in the Czech Republic.
Design: Prospective, multicentre, questionnaire, correspondence study.
Settings: Anaesthetic departments, Czech Republic.
Material and methods:We posted a structured questionnaire regarding the use and choice of muscle relaxants
depending on the length of surgery to the heads of 140 Czech departments of anaesthesia.We were
also interested in the methods and techniques of neuromuscular blockade monitoring and the dose regimens
for block reversal by neostigmine. Descriptive statistics were used to analyze the results.
Results: 96% of the questionnaires returned. Nine neuromuscular blockers are currently available in the
Czech Republic (suxamethonium, alcuronium, atracurium, cisatracurium, mivacurium, pancuronium, pipecuronium,
rocuronium and vecuronium). Atracurium (74%), cisatracurium (41%) and vecuronium (20%) are
the most preferred ones. Suxamethonium is most commonly used for patients at risk of aspiration (91%)
and those with potential difficult airways (75%). A bolus dose with or without top-ups is the most frequent
strategy of administration.Timing (63%) is the most commonly used special procedure followed by priming
(31%) and precurarization (22%). Monitoring of neuromuscular blockade relies mainly on clinical judgement
(73%), as 50% of departments do not have the monitoring equipment. This is based on expert (40%),
economical (42%) and technical (25%) reasons. Neostigmine is usually administered according to clinical
signs (90%). The most frequently used dose is 1.0 mg.
Conclusion: The same muscle relaxants are used in the Czech Republic as worldwide. An initial bolus and
top-ups is the most frequently used strategy for muscle relaxation. There is a noteworthy lack of monitoring
facilities in Czech anaesthetic departments. A relatively small dose of neostigmine is used for reversal.
Key words:
neuromuscular blockade – neuromuscular blocker – neostigmine – monitoring – questionnaire
survey
|