hrvatski

Dinamika neuromuskularne funkcije u Bier-ovom bloku

Bier's block (IVRA) is simple, save and high-effective technique of regional anaesthesia, useful for the most hand, wrist and forearm surgical intervention. Muscle relaxation in IVRA does not improve good surgical condition for all procedures. In rare cases, supplementation of non-depolarising muscle relaxants atracurium, allows good surgery condition but prolongs unwanted paralysis of the limb postoperatively. Dynamic of neuromuscular function and establishment of the real need for muscle relaxant supplementation in IVRA was the aim of this study. Also, the study tried to answer if sugamadex could be effective in avoidance of post-deflation limb paralysis caused by rocuronium supplementation. The main results showed satisfactory NM block during IVRA (≤5% TOF-a). It was sufficient for most surgery but not for intervention where complete muscle relaxation is needed. Complete NM block was found 5 min after application of local anaesthetic solution where low-dose of rocuronium was added (0/4 TOF-a). The supplementation of rocuronium in IVRA is justified only by strong indication. In these cases, sugamadex has to be used to eliminate potential rocuronium adverse effects and to reduce limb paralysis on acceptable 40 minutes postoperatively.

regionalna anestetzija; Bierov blok; IVRA; neuromuskularna funkcija

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