Unterschätzte postoperative Risiken durch Muskelrelaxanzien – Nachgehakt bei Prof. Dr. Matthias Eikermann

Die meisten Anästhesisten verwenden regelmäßig Muskelrelaxanzien. Dass sie postoperativ Komplikationen mit sich bringen können, ist bekannt. Inwiefern diese klinisch relevant werden und ob man sie durch Antagonisierung mildern kann, hat eine Arbeitsgruppe der Harvard Medical School (Boston, USA) anhand eines großen Patientenkollektivs untersucht [1]. Wir haben nachgehakt beim korrespondierenden Autor Prof. Dr. Matthias Eikermann.

• Literatur

• 1 Grosse-Sundrup M, Hennemann JP, Sandberg WS et al. Intermediate acting non-depolarizing neuromuscular blocking agents and risk of postoperative respiratory complications: prospective propensity score matched cohort study. BMJ 2012; 345
• 2 Beecher HK, Todd DP. A study of the deaths associated with anesthesia and surgery: based on a study of 599,548 anesthesias in ten institutions 1948–1952, inclusive. Ann Surg 1954; 140: 2-35
• 3 Abajian J, Arrowood JG, Barrett RH et al. Critique of „A Study of the Deaths Associated with Anesthesia and Surgery“. Ann Surg 1955; 142: 138-141
• 4 Pedersen T, Viby-Mogensen J, Ringsted C. Anaesthetic practice and postoperative pulmonary complications. Acta Anaesthesiol Scand 1992; 36: 812-818
• 5 Harrison GG. Death attributable to anaesthesia. A 10-year survey (1967–1976). Br J Anaesth 1978; 50: 1041-1046
• 6 Lunn JN, Hunter AR, Scott DB. Anaesthesia-related surgical mortality. Anaesthesia 1983; 38: 1090-1096
• 7 Rose DK, Cohen MM, Wigglesworth DF, DeBoer DP. Critical respiratory events in the postanesthesia care unit. Patient, surgical, and anesthetic factors. Anesthesiology 1994; 81: 410-418
• 8 Sprung J, Warner ME, Contreras MG et al. Predictors of survival following cardiac arrest in patients undergoing noncardiac surgery: a study of 518,294 patients at a tertiary referral center. Anesthesiology 2003; 99: 259-269
• 9 Arbous MS, Meursing AE, van Kleef JW et al. Impact of anesthesia management characteristics on severe morbidity and mortality. Anesthesiology 2005; 102: 491-252
• 10 Segredo V, Caldwell JE, Matthay MA et al. Persistent paralysis in critically ill patients after long-term administration of vecuronium. N Engl J Med 1992; 327: 524-528
• 11 Eikermann M, Groeben H, Bunten B, Peters J. Fade of pulmonary function during residual neuromuscular blockade. Chest 2005; 127: 1703-1709
• 12 Eikermann M, Vogt FM, Herbstreit F et al. The predisposition to inspiratory upper airway collapse during partial neuromuscular blockade. Am J Respir Crit Care Med 2007; 175: 9-15
• 13 Butterly A, Bittner EA, George E et al. Postoperative residual curarization from intermediate-acting neuromuscular blocking agents delays recovery room discharge. Br J Anaesth 2010; 105: 304-309
• 14 Murphy GS. Residual neuromuscular blockade: incidence, assessment, and relevance in the postoperative period. Minerva Anestesiol 2006; 72: 97-109
• 15 Murphy GS, Szokol JW, Marymont JH et al. Residual neuromuscular blockade and critical respiratory events in the postanesthesia care unit. Anesth Analg 2008; 107: 130-137
• 16 Sundman E, Witt H, Olsson R et al. The incidence and mechanisms of pharyngeal and upper esophageal dysfunction in partially paralyzed humans: pharyngeal videoradiography and simultaneous manometry after atracurium. Anesthesiology 2000; 92: 977-984
• 17 Kopman AF, Eikermann M. Antagonism of non-depolarising neuromuscular block: current practice. Anaesthesia 2009; 64 (Suppl. 01) 22-30
• 18 Payne JP, Hughes R, Al Azawi S. Neuromuscular blockade by neostigmine in anaesthetized man. Br J Anaesth 1980; 52: 69-76
• 19 Caldwell JE. Reversal of residual neuromuscular block with neostigmine at one to four hours after a single intubating dose of vecuronium. Anesth Analg 1995; 80: 1168-1174
• 20 Eikermann M, Fassbender P, Malhotra A et al. Unwarranted administration of acetylcholinesterase inhibitors can impair genioglossus and diaphragm muscle function. Anesthesiology 2007; 107: 621-629
• 21 Wilcox SR, Bittner EA, Elmer J et al. Neuromuscular blocking agent administration for emergent tracheal intubation is associated with decreased prevalence of procedure-related complications. Crit Care Med 2012; 40: 1808-1813
• 22 Eikermann M, Hunkemoller I, Peine L et al. Optimal rocuronium dose for intubation during inhalation induction with sevoflurane in children. Br J Anaesth 2002; 89: 277-281
• 23 Mencke T, Echternach M, Kleinschmidt S et al. Laryngeal morbidity and quality of tracheal intubation: a randomized controlled trial. Anesthesiology 2003; 98: 1049-1056
• 24 Williams MT, Rice I, Ewen SP, Elliott SM. A comparison of the effect of two anaesthetic techniques on surgical conditions during gynaecological laparoscopy. Anaesthesia 2003; 58: 574-578
• 25 Alfille PH, Merritt C, Chamberlin NL, Eikermann M. Control of perioperative muscle strength during ambulatory surgery. Curr Opin Anaesthesiol 2009; 22: 730-737
• 26 Ma D, Zhang B, Hoffmann U et al. Acyclic Cucurbit[n]uril-Type Molecular Containers Bind Neuromuscular Blocking Agents In Vitro and Reverse Neuromuscular Block In Vivo. Angew Chem Int Ed Engl 2012; 51: 11358-11362
• 27 Savarese JJ, McGilvra JD, Sunaga H et al. Rapid chemical antagonism of neuromuscular blockade by L-cysteine adduction to and inactivation of the olefinic (double-bonded) isoquinolinium diester compounds gantacurium (AV430A), CW 002, and CW 011. Anesthesiology 2010; 113: 58-73