Research article Authors: Spurti Kalburgi , Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, IN X close Handattu Mahabaleswara Krishna, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, IN X close Ajith kumar Pillai Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, IN X close Abstract Background and aims Use of neostigmine to reverse the non-depoloarizing neuromuscular block at the end of the surgery is a standard practice. Reversal with neostigmine based on body weight is still commonly followed. However, neostigmine may affect adversely if used empirically in the absence of residual blockade. This study compares the empirical technique of reversal based on body weight with reversal using neostigmine dose adjusted to train-of-four (TOF) response. Methods This prospective, double-blinded, randomized controlled trial included 126 patients undergoing surgery under general anaesthesia, lasting for >1 hour. They were randomized into group control receiving weight based reversal (0.05 mg/kg neostigmine) and group study receiving dose determined by TOF response. Signs of residual paralysis after extubation were observed. TOF ratios/count, reversal to extubation time, dose and side-effects of reversal agent were also noted. Results Patient characteristics were comparable in both groups. Number of patients with signs of residual weakness was less in group study (26/63), but comparable to group control (40/63, p=0.094). Number of patients with TOF≥0.9 at reversal and extubation was significantly high in group study (40/63) than group control (22/63), and number of patients with TOF count How to Cite: Kalburgi, S., Krishna, H.M. and Pillai, A. kumar ., 2022. Reversal of Neuromuscular Blockade Based on Train of Four Response: a Prospective Randomized Controlled Trial. Sri Lankan Journal of Anaesthesiology, 30(2), pp.112–117. DOI: http://doi.org/10.4038/slja.v30i2.8790

Published on 05 Oct 2022.

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