Objective: To assess the incidence of postoperative residual curarization following cisatracurium and rocuronium-induced neuromuscular block. Design: Clinical, prospective, controlled study. Setting: Department of Anaesthesiology and Intensive Care Medicine, University Hospital, Materials and methods: We investigated residual curarization after generál anaesthesia with either cisat¬racurium (CIS, n = 384) or rocuronium (ROC, n = 406) induced neuromuscular blockade without peropera-tive neuromuscular blockade monitoring in 790 patients. On admission to the recovery room we perfor-med submaximal stimulation of the ulnar nerve (30 mA) and quantified the evoked muscle response with accelerometry (TOF-Watch® SX, Organon). The postoperative residual curarization was defined as TOF-ratio < 0.90, p < 0.05 was considered significant. Results: Postoperative residual curarization could be demonstrated in 24.5 % (CIS group) and 32.0 % (ROC group), respectively. Compared to the group with adequate neuromuscular recovery, the patients with residual blockade received a larger relaxant dose, were anaesthetised by a less experienced anaesthetist, a shorter time had elapsed since the last relaxant dose, their core temperature was lower and on average, they received less neostigmine at the end of anaesthesia (p < 0.05). Conclusion: The incidence of postoperative residual curarization remains a problém even following intermediate-acting neuromuscular blockers (cisatracurium, rocuronium). We suggest reversing the residual block after cisatracurium or rocuronium routinely, especially in the absence of perioperative neuromuscular monitoring.

        Key words: postoperative residual curarization - cisatracurium - rocuronium - TOF-ratio - postanaesthesia care unit