Respiratory function in children during recovery from neuromuscular blockade

Paediatr Anaesth. 1998;8(1):41-7. doi: 10.1046/j.1460-9592.1998.00711.x.

Abstract

Residual neuromuscular blockade is a major risk factor for respiratory insufficiency. We examined the relationship between neuromuscular and respiratory function in 18 ASA I or II children aged 2-4 years. Lung function was measured by pneumotachography and transpulmonary pressure, neuromuscular transmission by first twitch response ratio (T1:T1) and train-of-four ratio (TOFR), before and at specific points in recovery from vecuronium paralysis. The tidal volume was directly related to maximal inspiratory pressure at occlusion (PIOCC), P < 0.001, whereas the minute ventilation (VE) was related to the respiratory drive (P0.1), P < 0.001. The best predictors of minute ventilation were the P0.1 (r = 0.57), and the TOFR (r = 0.62). PIOCC and P0.1 correlated closely (r = 0.889, P = 0.002) but TOFR and T1:T1 did not correlate with either. Our results show that the occlusion pressure measurements, P0.1 and PIOCC, were good predictors of both VE.kg-1 and respiratory work.

MeSH terms

  • Anesthesia Recovery Period*
  • Child, Preschool
  • Humans
  • Neuromuscular Blockade*
  • Neuromuscular Junction / drug effects
  • Neuromuscular Junction / physiology
  • Respiratory Mechanics*
  • Respiratory Muscles / drug effects
  • Respiratory Muscles / physiology
  • Synaptic Transmission / drug effects