RECOVERY FROM NEUROMUSCULAR BLOCKADE - RESIDUAL CURARIZATION FOLLOWING ATRACURIUM OR VECURONIUM BY BOLUS DOSING OR INFUSIONS

We conducted a survey of the incidence of Postoperative Residual Curar isation (PORC) in two groups of patients following the use of atracuri um or vecuronium. In the first group (B) the neuromuscular blocking dr ugs were administered by bolus dosing, and in the second group (T) by continuous infusion. On arrival in the recovery room, neuromuscular fu nction was assessed both by compound evoked electromyogram (EMG) in a train of four pattern and also clinically, by the ability to sustain a headlift for >5 seconds, and to cough. Results were obtained from 150 patients (100 in group B and 50 in group I). The incidence of PORC, a s defined by a vain of four ratio of <0.7, on arrival in the recovery room was 12% in group B, and 24% in group I. Clinical criteria of adeq uate neuromuscular reversal revealed different results, with the major ity of patients being unable to perform either clinical test on arriva l in recovery. Those patients in whom a peripheral nerve stimulator wa s used intraoperatively did not have a reduced incidence of PORC. We h ave demonstrated that PORC is still a common occurrence even with inte rmediate duration of action neuromuscular blocking drugs.