Neuromuscular monitoring, muscle relaxant use, and reversal at a tertiary teaching hospital 2.5 Years after introduction of sugammadex: Changes in opinions and clinical practice

Thomas Ledowski, J.S. Ong, T. Flett

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    Abstract

    Copyright © 2015 Thomas Ledowski et al. Sugammadex was introduced to Royal Perth Hospital in early 2011 without access restriction. Two departmental audits (26-page online survey and 1-week in-theatre snapshot audit) were undertaken to investigate the change of beliefs and clinical practice related to the use of neuromuscular blocking agents at the Royal Perth Hospital since this introduction. Results were compared with data from 2011. We found that, in the 2.5 years since introduction of Sugammadex, more anesthetists (69.5 versus 38%) utilized neuromuscular monitoring, and aminosteroidal neuromuscular blocking agents were used in 94.3% of cases (versus 77% in 2011). Furthermore, 53% of anesthetists identified with a practice of "deeper and longer" intraoperative paralysis of patients. All 71 patients observed during the 5-day in-theatre audit were reversed with Sugammadex. Since the introduction of Sugammadex, 69% (n = 20) of respondents felt it provided "faster turnover," less postoperative residual neuromuscular blockade (n = 23; 79%), and higher anesthetist satisfaction (n = 17; 59%). 45%(n = 13) of colleagues reported that they would feel professionally impaired without the unrestricted availability of Sugammadex, and 1 colleague would refuse to work in a hospital without this drug being freely available. In clinical practice Sugammadex was frequently (57%) mildly overdosed, with 200mg being the most commonly administered dose.
    Original languageEnglish
    Pages (from-to)1-4
    JournalAnesthesiology Research and Practice
    Volume2015
    DOIs
    Publication statusPublished - 2015

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    Neuromuscular Monitoring
    Tertiary Care Centers
    Teaching Hospitals
    Muscles
    Neuromuscular Blocking Agents
    Delayed Emergence from Anesthesia
    Paralysis
    Sugammadex
    Pharmaceutical Preparations

    Cite this

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    title = "Neuromuscular monitoring, muscle relaxant use, and reversal at a tertiary teaching hospital 2.5 Years after introduction of sugammadex: Changes in opinions and clinical practice",
    abstract = "Copyright {\circledC} 2015 Thomas Ledowski et al. Sugammadex was introduced to Royal Perth Hospital in early 2011 without access restriction. Two departmental audits (26-page online survey and 1-week in-theatre snapshot audit) were undertaken to investigate the change of beliefs and clinical practice related to the use of neuromuscular blocking agents at the Royal Perth Hospital since this introduction. Results were compared with data from 2011. We found that, in the 2.5 years since introduction of Sugammadex, more anesthetists (69.5 versus 38{\%}) utilized neuromuscular monitoring, and aminosteroidal neuromuscular blocking agents were used in 94.3{\%} of cases (versus 77{\%} in 2011). Furthermore, 53{\%} of anesthetists identified with a practice of {"}deeper and longer{"} intraoperative paralysis of patients. All 71 patients observed during the 5-day in-theatre audit were reversed with Sugammadex. Since the introduction of Sugammadex, 69{\%} (n = 20) of respondents felt it provided {"}faster turnover,{"} less postoperative residual neuromuscular blockade (n = 23; 79{\%}), and higher anesthetist satisfaction (n = 17; 59{\%}). 45{\%}(n = 13) of colleagues reported that they would feel professionally impaired without the unrestricted availability of Sugammadex, and 1 colleague would refuse to work in a hospital without this drug being freely available. In clinical practice Sugammadex was frequently (57{\%}) mildly overdosed, with 200mg being the most commonly administered dose.",
    author = "Thomas Ledowski and J.S. Ong and T. Flett",
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    N2 - Copyright © 2015 Thomas Ledowski et al. Sugammadex was introduced to Royal Perth Hospital in early 2011 without access restriction. Two departmental audits (26-page online survey and 1-week in-theatre snapshot audit) were undertaken to investigate the change of beliefs and clinical practice related to the use of neuromuscular blocking agents at the Royal Perth Hospital since this introduction. Results were compared with data from 2011. We found that, in the 2.5 years since introduction of Sugammadex, more anesthetists (69.5 versus 38%) utilized neuromuscular monitoring, and aminosteroidal neuromuscular blocking agents were used in 94.3% of cases (versus 77% in 2011). Furthermore, 53% of anesthetists identified with a practice of "deeper and longer" intraoperative paralysis of patients. All 71 patients observed during the 5-day in-theatre audit were reversed with Sugammadex. Since the introduction of Sugammadex, 69% (n = 20) of respondents felt it provided "faster turnover," less postoperative residual neuromuscular blockade (n = 23; 79%), and higher anesthetist satisfaction (n = 17; 59%). 45%(n = 13) of colleagues reported that they would feel professionally impaired without the unrestricted availability of Sugammadex, and 1 colleague would refuse to work in a hospital without this drug being freely available. In clinical practice Sugammadex was frequently (57%) mildly overdosed, with 200mg being the most commonly administered dose.

    AB - Copyright © 2015 Thomas Ledowski et al. Sugammadex was introduced to Royal Perth Hospital in early 2011 without access restriction. Two departmental audits (26-page online survey and 1-week in-theatre snapshot audit) were undertaken to investigate the change of beliefs and clinical practice related to the use of neuromuscular blocking agents at the Royal Perth Hospital since this introduction. Results were compared with data from 2011. We found that, in the 2.5 years since introduction of Sugammadex, more anesthetists (69.5 versus 38%) utilized neuromuscular monitoring, and aminosteroidal neuromuscular blocking agents were used in 94.3% of cases (versus 77% in 2011). Furthermore, 53% of anesthetists identified with a practice of "deeper and longer" intraoperative paralysis of patients. All 71 patients observed during the 5-day in-theatre audit were reversed with Sugammadex. Since the introduction of Sugammadex, 69% (n = 20) of respondents felt it provided "faster turnover," less postoperative residual neuromuscular blockade (n = 23; 79%), and higher anesthetist satisfaction (n = 17; 59%). 45%(n = 13) of colleagues reported that they would feel professionally impaired without the unrestricted availability of Sugammadex, and 1 colleague would refuse to work in a hospital without this drug being freely available. In clinical practice Sugammadex was frequently (57%) mildly overdosed, with 200mg being the most commonly administered dose.

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