ABSTRACT

In our study we aimed to compare the occurrence of residual curarization after extubation based on clinical observation with antagonization using neostigmine in patients randomized into rocuronium or atracurium groups.

Sixty five patients in physical status ASA I-II group undergoing abdominal hysterectomy were randomly assigned to two groups as rocuronium 0.6 mg kg-1 (Group R) or atracurium 0.5 mg kg-1 (Group A). At the end of the operation all patients were antagonized with neostigmine, and extubated according to clinical extubation criteria. TOF values at the time of extubation and at 1., 3., 5., 10. minutes after extubation, duration of operation and anaesthesia, total fentanyl, neuromuscular blocker agent, and neostigmine doses were recorded.

Demographic characteristics of the patients, duration of operation and anaesthesia, total fentanyl, neuromuscular blocker, and neostigmine doses were similar in two groups. TOF ratio at the time extubation was <0.7 in all patients extubated according to clinical observation criteria . Although TOF ratio was significantly lower in Group R compared to Group A at the time of extubation and 1., 3. min after extubation (p<0.05), there were no significant differences at the other time intervals. In all patients time to a TOF ratio of ≥0.7 and ≥0.9 were 5. min and 10. min respectively in patients extubated based on clinical observation.

In our study, we concluded that TOF monitorization is a useful method in determination the presence, and also prevention of residual curarization and the incidence of residual blockade was found to be similar after administration of either rocuronium or atracurium following reversal with neostigmine.

Keywords: Neuromuscular block, monitorization, residual curarization, rocuronium, atracurium