Postoperatif rezidüel blok ve komplikasyonları

Kas gevşeticiler genel anestezi pratiğinde endotrakeal entübasyon ve intraoperatif kas gevşemesi amacıyla sıkça kullanılmaktadırlar. Ancak ciddi yan etkilerinin olabileceği göz ardı edilmemelidir. Kas gevşetici kullanımını takiben gelişen postoperatif felç hali olarak tanımlanan postoperatif rezidüel blok (PORB) bu yan etkilerden biri olarak tanımlanmaktadır. Bu durum mide içeriğinin aspirasyonu, havayolu tıkanıklığı ve solunumun baskılanması gibi ciddi komplikasyonlara neden olabilir. PORB'u önlemek için ekstübasyon öncesi objektif ve kantitatif nöromüsküler sinir kas kavşağı monitörizasyonları gerekmektedir. Havayolunun korunması için 0,9'dan büyük TOF değeri gereklidir. Kas gevşeticiler in etkilerini hızla geri döndürmek için olduğu kadar, ayrıca cerrahi girişimin bitiminde PORB'un idamesi amacıyla da asetilkolin esteraz veya sugammadex gibi kas gevşeticilerin etkilerini geri dönüştüren ajanlar kullanılmaktadır.

Postoperative residual block and complications

In general anesthesia practice the neuromuscular blockers are being widely used for endotracheal intubation and intraoperative muscle relaxation. However, it should not be neglected that they might also have severe side effects. One of those side effects is postoperative residual block (PORB) which is a state of postoperative paralysis when these agents are used. This could cause serious complications like aspiration of gastric content, airway obstruction and respiratory depression. In order to prevent PORB, objective and quantitative neuromuscular junction monitorisation before extubation is required. For the protection of the airway a TOF value of >0.9 is necessary. Not only to rapidly reverse the effects of muscle relaxants, but also to manage PORB at the end of the surgical procedure, agents that reverse the effects of muscle relaxants like asetilcholine esterase inhibitors or sugammadex are being used.

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