RESPIRATORY-FUNCTION IN CHILDREN DURING RECOVERY FROM NEUROMUSCULAR BLOCKADE

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) an d train-of-four ratio (TOFR), before and at specific points in recover y from vecuronium paralysis. The tidal volume was directly related to maximal inspiratory pressure at occlusion (P(I)occ), P<0.001, whereas the minute ventilation (V-E) 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). P(I)occ 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 P(I)o cc, were good predictors of both V-E.kg(-1) and respiratory work.