Recuperación neuromuscular evaluada mediante Train-of-Four en cirugía estética bajo anestesia general con rocuronio frente a cisatracurium en la detección de relajación residual

datacite.rightshttp://purl.org/coar/access_right/c_f1cf
dc.contributor.advisorMorales Roncallo, Antonio José
dc.contributor.advisorGonzález Torres, Henry Joseth
dc.contributor.authorDagil Chinchia, Ana Milena
dc.contributor.authorRuiz Pastrana, Karen Lucia
dc.date.accessioned2026-02-03T14:43:27Z
dc.date.available2026-02-03T14:43:27Z
dc.date.issued2025
dc.description.abstractLa relajación neuromuscular residual continúa siendo una complicación relevante en anestesia general, especialmente en cirugía estética, donde los procedimientos prolongados y el sobrepeso aumentan el riesgo de eventos respiratorios postoperatorios. Aunque rocuronio y cisatracurium son los bloqueadores neuromusculares más utilizados, la evidencia comparativa sobre su recuperación medida mediante Train-of-Four (TOF) en población estética latinoamericana es limitada. Objetivo: Comparar la recuperación neuromuscular evaluada mediante Train-ofFour en pacientes sometidas a cirugía estética bajo anestesia general con rocuronio frente a cisatracurium, determinando la incidencia de relajación neuromuscular residual (TOF < 0.9) y los factores clínicos y anestésicos asociados en el postoperatorio inmediato.spa
dc.description.abstractResidual neuromuscular blockade remains a relevant complication in general anesthesia, particularly in aesthetic surgery, where prolonged procedures and overweight increase the risk of postoperative respiratory events. Although rocuronium and cisatracurium are the most widely used neuromuscular blockers, comparative evidence on their recovery profiles measured by Train-of-Four (TOF) in Latin American aesthetic surgery populations is limited. Objective: To compare neuromuscular recovery assessed by Train-of-Four in patients undergoing aesthetic surgery under general anesthesia with rocuronium versus cisatracurium, determining the incidence of residual neuromuscular blockade (TOF < 0.9) and the associated clinical and anesthetic factors in the immediate postoperative period.eng
dc.format.mimetypepdf
dc.identifier.urihttps://hdl.handle.net/20.500.12442/17329
dc.language.isospa
dc.publisherEdiciones Universidad Simón Bolívarspa
dc.publisherFacultad de Ciencias de la Saludspa
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 Internationaleng
dc.rights.accessrightsinfo:eu-repo/semantics/embargoedAccess
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectRelajación neuromuscular residualspa
dc.subjectRocuroniospa
dc.subjectCisatracuriumspa
dc.subjectCirugía estéticaspa
dc.subjectMonitoreo neuromuscularspa
dc.subjectAnestesia generalspa
dc.subject.keywordsResidual neuromuscular blockadeeng
dc.subject.keywordsTrain-of-Foureng
dc.subject.keywordsRocuroniumeng
dc.subject.keywordsCisatracuriumeng
dc.subject.keywordsAesthetic surgeryeng
dc.subject.keywordsNeuromuscular monitoringeng
dc.subject.keywordsGeneral anesthesiaeng
dc.titleRecuperación neuromuscular evaluada mediante Train-of-Four en cirugía estética bajo anestesia general con rocuronio frente a cisatracurium en la detección de relajación residualspa
dc.type.driverinfo:eu-repo/semantics/other
dc.type.spaOtros
dcterms.referencesMurphy GS, Brull SJ. Residual neuromuscular block: lessons unlearned. Part I: definitions, incidence, and adverse physiologic effects of residual neuromuscular block. Anesth Analg 2010;111:120–8. https://doi.org/10.1213/ANE.0b013e3181da832d.eng
dcterms.referencesHattori J, Tanaka A, Kosaka J, Hirao O, Furushima N, Maki Y, et al. Clinical predictors of extubation failure in postoperative critically ill patients: a posthoc analysis of a multicenter prospective observational study. BMC Anesthesiol 2025;25:127. https://doi.org/10.1186/s12871-025-02996-1.eng
dcterms.referencesNaguib M, Kopman AF, Lien CA, Hunter JM, Lopez A, Brull SJ. A survey of current management of neuromuscular block in the United States and Europe. Anesth Analg 2010;111:110–9. https://doi.org/10.1213/ANE.0b013e3181c07428.eng
dcterms.referencesFortier L-P, McKeen D, Turner K, de Médicis É, Warriner B, Jones PM, et al. The RECITE Study: A Canadian Prospective, Multicenter Study of the Incidence and Severity of Residual Neuromuscular Blockade. Anesth Analg 2015;121:366–72. https://doi.org/10.1213/ANE.0000000000000757eng
dcterms.referencesThilen SR, Weigel WA. Neuromuscular Blockade Monitoring. Anesthesiol Clin 2021;39:457–76. https://doi.org/10.1016/j.anclin.2021.05.001.eng
dcterms.referencesDonati F. Neuromuscular monitoring: what evidence do we need to be convinced? Anesth Analg 2010;111:6–8. https://doi.org/10.1213/ANE.0b013e3181cdb093.eng
dcterms.referencesRobertson EN, Driessen JJ, Vogt M, De Boer H, Scheffer GJ. Pharmacodynamics of rocuronium 0.3 mg kg(-1) in adult patients with and without renal failure. Eur J Anaesthesiol 2005;22:929–32. https://doi.org/10.1017/S0265021505001584.eng
dcterms.referencesFarag E, Rivas E, Bravo M, Hussain S, Argalious M, Khanna S, et al. Sugammadex Versus Neostigmine for Reversal of Rocuronium Neuromuscular Block in Patients Having Catheter-Based Neurointerventional Procedures: A Randomized Trial. Anesth Analg 2021;132:1666–76. https://doi.org/10.1213/ANE.0000000000005533eng
dcterms.referencesMellinghoff H, Diefenbach C. [The clinical pharmacology of cisatracurium]. Anaesthesist 1997;46:481–5. https://doi.org/10.1007/s001010050427.eng
dcterms.referencesLepage JY, Malinovsky JM, Malinge M, Lechevalier T, Dupuch C, Cozian A, et al. Pharmacodynamic dose-response and safety study of cisatracurium (51W89) in adult surgical patients during N2O-O2-opioid anesthesia. Anesth Analg 1996;83:823–9. https://doi.org/10.1097/00000539-199610000-00030.eng
dcterms.referencesHanley MJ, Abernethy DR, Greenblatt DJ. Effect of obesity on the pharmacokinetics of drugs in humans. Clin Pharmacokinet 2010;49:71–87. https://doi.org/10.2165/11318100-000000000-00000.eng
dcterms.referencesAriza F, Dorado F, Enríquez LE, González V, Gómez JM, ChaparroMendoza K, et al. Postoperative residual curarization at the post-anesthetic care unit of a university hospital: A cross-sectional study. Colomb J Anesthesiol 2017;45:15–21. https://doi.org/10.1016/j.rcae.2016.11.002.eng
dcterms.referencesDavis LA, Fogarty MJ, Brown A, Sieck GC. Structure and Function of the Mammalian Neuromuscular Junction. Compr Physiol 2022;12:3731–66. https://doi.org/10.1002/cphy.c210022.eng
dcterms.referencesUnwin N. Nicotinic acetylcholine receptor and the structural basis of neuromuscular transmission: insights from Torpedo postsynaptic membranes. Q Rev Biophys 2013;46:283–322. https://doi.org/10.1017/S0033583513000061.eng
dcterms.referencesTintignac LA, Brenner H-R, Rüegg MA. Mechanisms Regulating Neuromuscular Junction Development and Function and Causes of Muscle Wasting. Physiol Rev 2015;95:809–52. https://doi.org/10.1152/physrev.00033.2014.eng
dcterms.referencesNaguib M, Brull SJ, Johnson KB. Conceptual and technical insights into the basis of neuromuscular monitoring. Anaesthesia 2017;72 Suppl 1:16–37. https://doi.org/10.1111/anae.13738eng
dcterms.referencesDuţu M, Ivaşcu R, Tudorache O, Morlova D, Stanca A, Negoiţă S, et al. Neuromuscular monitoring: an update. Rom J Anaesth Intensive Care 2018;25:55–60. https://doi.org/10.21454/rjaic.7518.251.nrm.eng
dcterms.referencesAragón-Benedí C, Pascual-Bellosta A, Ortega-Lucea S, Visiedo-Sánchez S, Martínez-Ubieto J, Research Group in Anaesthesia, Resuscitation and PM of I for HRA (ISS A. Predictive study of pharmacological reversal for residual neuromuscular blockade and postoperative pulmonary complications: a prospective, observational, cohort study. Sci Rep 2022;12:14955. https://doi.org/10.1038/s41598-022-18917-y.eng
dcterms.referencesBucheery BA, Isa HM, Rafiq O, Almansoori NA, Razaq ZAA, Gawe ZA, et al. Residual Neuromuscular Blockade and Postoperative Pulmonary Complications in the Post-anesthesia Care Unit: A Prospective Observational Study. Cureus 2023. https://doi.org/10.7759/cureus.51013.eng
dcterms.referencesVélez-Agudelo DL, Salazar-Cortés SA, García A, Casas-Arroyave FD. Incidence of postoperative residual neuromuscular blockade: a prospective observational study. Colomb J Anesthesiol 2025;53. https://doi.org/10.5554/22562087.e1146.eng
dcterms.referencesKirmeier E, Eriksson LI, Lewald H, Jonsson Fagerlund M, Hoeft A, Hollmann M, et al. Post-anaesthesia pulmonary complications after use of muscle relaxants (POPULAR): a multicentre, prospective observational study. Lancet Respir Med 2019;7:129–40. https://doi.org/10.1016/S2213- 2600(18)30294-7.eng
dcterms.referencesBrull SJ, Kopman AF. Current Status of Neuromuscular Reversal and Monitoring: Challenges and Opportunities. Anesthesiology 2017;126:173–90. https://doi.org/10.1097/ALN.0000000000001409.eng
dcterms.referencesCammu G. Residual Neuromuscular Blockade and Postoperative Pulmonary Complications: What Does the Recent Evidence Demonstrate? Curr Anesthesiol Rep 2020;10:131–6. https://doi.org/10.1007/s40140-020-00388- 4.eng
dcterms.referencesSzewczyk M, Bieniecka A, Sobolewski K, Banasiak Ł, Grabarczyk Ł. Neuromuscular Blocking Agents and Reversal Agents Usage, and Neuromuscular Blockade Monitoring in the Intensive Care Unit - Review Article. Int J Gen Med 2025;18:3651–88. https://doi.org/10.2147/IJGM.S524089.eng
dcterms.referencesFrenkel M, Lien CA. Eliminating residual neuromuscular blockade: a literature review. Ann Transl Med 2024;12:65–65. https://doi.org/10.21037/atm-23-1743.eng
dcterms.referencesBlum FE, Locke AR, Nathan N, Katz J, Bissing D, Minhaj M, et al. Residual Neuromuscular Block Remains a Safety Concern for Perioperative Healthcare Professionals: A Comprehensive Review. J Clin Med 2024;13. https://doi.org/10.3390/jcm13030861.eng
dcterms.referencesJung KT, An TH. Updated review of resistance to neuromuscular blocking agents. Anesth Pain Med 2018;13:122–7. https://doi.org/10.17085/apm.2018.13.2.122.eng
dcterms.referencesFeltracco P, Tonetti T, Barbieri S, Frigo AC, Ori C. Cisatracurium- and rocuronium-associated residual neuromuscular dysfunction under intraoperative neuromuscular monitoring and postoperative neostigmine reversal: a single-blind randomized trial. J Clin Anesth 2016;35:198–204. https://doi.org/10.1016/j.jclinane.2016.07.031.eng
dcterms.referencesErstad BL, Barletta JF. Dosing of neuromuscular blocking agents in patients with obesity: A narrative review. Anaesth Intensive Care 2021;49:98–104. https://doi.org/10.1177/0310057X20968573.eng
dcterms.referencesDoo AR, Lee JH, Lee Y, Ko S. Influence of the amount of skeletal muscle mass on rocuronium-induced neuromuscular block. Anaesthesia, Crit Care Pain Med 2022;41:101086. https://doi.org/10.1016/j.accpm.2022.101086.eng
dcterms.referencesHu Z, Li B, Li Z, Liu Z, Liu S. Feasibility of calculating rocuronium dosage by skeletal muscle weight in patients with obesity. Front Med 2024;11. https://doi.org/10.3389/fmed.2024.1399475.eng
dcterms.referencesHuang X, Chen L, Cai Y, Wei J, Lin L, Sun J, et al. Abnormal cisatracurium pharmacodynamics and pharmacokinetics among patients with severe aortic regurgitation during anesthetic induction. BMC Anesthesiol 2020;20:21. https://doi.org/10.1186/s12871-020-0935-z.eng
dcterms.referencesKhan R, Kaul N, Nair R. Cisatracurium degradation: Intravenous fluid warmer the culprit? Indian J Anaesth 2015;59:323. https://doi.org/10.4103/0019- 5049.156893.eng
dcterms.referencesMotamed C. Intraoperative Monitoring of Neuromuscular Blockade. Life (Basel, Switzerland) 2023;13. https://doi.org/10.3390/life13051184.eng
dcterms.referencesThilen SR, Weigel WA, Todd MM, Dutton RP, Lien CA, Grant SA, et al. 2023 American Society of Anesthesiologists Practice Guidelines for Monitoring and Antagonism of Neuromuscular Blockade: A Report by the American Society of Anesthesiologists Task Force on Neuromuscular Blockade. Anesthesiology 2023;138:13–41. https://doi.org/10.1097/ALN.0000000000004379.eng
dcterms.referencesBhananker SM, Treggiari MM, Sellers BA, Cain KC, Ramaiah R, Thilen SR. Comparison of train-of-four count by anesthesia providers versus TOFWatch® SX: a prospective cohort study. Can J Anaesth 2015;62:1089–96. https://doi.org/10.1007/s12630-015-0433-9.eng
dcterms.referencesAsztalos L, Boktor M, Kukuly M, Sólyom D, Pongrácz A, Brull SJ, et al. The Relationship Between Neuromuscular Block Depth and Airway Retroglossal Area: A Prospective, Nonrandomized, Observational Clinical Trial. J Clin Med 2025;14. https://doi.org/10.3390/jcm14124374.eng
dcterms.referencesLee W. The latest trend in neuromuscular monitoring: return of the electromyography. Anesth Pain Med 2021;16:133–7. https://doi.org/10.17085/apm.21014.eng
dcterms.referencesEdwards L-A, Ly N, Shinefeld J, Morewood G. Universal quantitative neuromuscular blockade monitoring at an academic medical center, A multimodal analysis of the potential impact on clinical outcomes and total cost of care. Perioper Care Oper Room Manag 2021;24:100184. https://doi.org/10.1016/j.pcorm.2021.100184.eng
dcterms.referencesRodney G, Raju PKBC, Brull SJ. Residual neuromuscular block: time to consign it to history. Anaesthesia 2024;79:344–8. https://doi.org/10.1111/anae.16238.eng
dcterms.referencesThe American Society of Plastic Surgeons. American Society of Plastic Surgeons. 2023.eng
dcterms.referencesInternational Society of Aesthetic Plastic Surgery (ISAPS). ISAPS INTERNATIONAL SURVEY ON AESTHETIC/COSMETIC PROCEDURES. 2020.eng
dcterms.referencesEllsworth WA, Basu CB, Iverson RE. Perioperative considerations for patient safety during cosmetic surgery - preventing complications. Can J Plast Surg 2009;17:9–16.eng
dcterms.referencesMotta FJTRA DA, Luna ICG, Fabiani IM, Souza JCDS, Amorim VEM, Sá JZ DE. Preoperative hypovitaminosis D and complications in plastic surgery: a pilot study. Rev Col Bras Cir 2024;51:e20243719. https://doi.org/10.1590/0100-6991e-20243719-en.eng
dcterms.referencesFischer JP, Wes AM, Serletti JM, Kovach SJ. Complications in body contouring procedures: an analysis of 1797 patients from the 2005 to 2010 American College of Surgeons National Surgical Quality Improvement Program databases. Plast Reconstr Surg 2013;132:1411–20. https://doi.org/10.1097/PRS.0b013e3182a806b3.eng
dcterms.referencesSakızcı-Uyar B, Çelik S, Postacı A, Bayraktar Y, Dikmen B, Özkoçak-Turan I, et al. Comparison of the effect of rocuronium dosing based on corrected or lean body weight on rapid sequence induction and neuromuscular blockade duration in obese female patients. Saudi Med J 2016;37:60–5. https://doi.org/10.15537/smj.2016.1.14099.eng
dcterms.referencesMurphy GS, Brull SJ. Quantitative Neuromuscular Monitoring and Postoperative Outcomes: A Narrative Review. Anesthesiology 2022;136:345–61. https://doi.org/10.1097/ALN.0000000000004044.eng
dcterms.referencesBijkerk V, Krijtenburg P, Verweijen T, Bruhn J, Scheffer GJ, Keijzer C, et al. Residual neuromuscular block in the postanaesthesia care unit: a singlecentre prospective observational study and systematic review. Br J Anaesth 2025;134:350–7. https://doi.org/10.1016/j.bja.2024.07.043.eng
dcterms.referencesEsteves S, Correia de Barros F, Nunes CS, Puga A, Gomes B, Abelha F, et al. Incidence of postoperative residual neuromuscular blockade - A multicenter, observational study in Portugal (INSPIRE 2). Porto Biomed J 2023;8:e225. https://doi.org/10.1097/j.pbj.0000000000000225.eng
dcterms.referencesSwanson E. Prospective Outcome Study of 360 Patients Treated with Liposuction, Lipoabdominoplasty, and Abdominoplasty. Plast Reconstr Surg 2012;129:965–78. https://doi.org/10.1097/PRS.0b013e318244237f.eng
dcterms.referencesNiu L, Wang Y, Yao C, Sun Y, Yao S, Lin Y. Efficacy and Safety of Neuromuscular Blockade in Overweight Patients Undergoing Nasopharyngeal Surgery. Med Sci Monit 2020;26. https://doi.org/10.12659/MSM.926452.eng
dcterms.referencesLemmens HJ. Perioperative pharmacology in morbid obesity. Curr Opin Anaesthesiol 2010;23:485–91. https://doi.org/10.1097/ACO.0b013e32833b0a8c.eng
dcterms.referencesKim KS, Cheong MA, Lee HJ, Lee JM. Tactile Assessment for the Reversibility of Rocuronium-Induced Neuromuscular Blockade During Propofol or Sevoflurane Anesthesia. Anesth Analg 2004;99:1080–5. https://doi.org/10.1213/01.ANE.0000130616.57678.80.eng
dcterms.referencesBlobner M, Eriksson LI, Scholz J, Motsch J, Della Rocca G, Prins ME. Reversal of rocuronium-induced neuromuscular blockade with sugammadex compared with neostigmine during sevoflurane anaesthesia: results of a randomised, controlled trial. Eur J Anaesthesiol 2010;27:874–81. https://doi.org/10.1097/EJA.0b013e32833d56b7.eng
dcterms.referencesPlaud B, Debaene B, Donati F, Marty J. Residual Paralysis after Emergence from Anesthesia. Anesthesiology 2010;112:1013–22. https://doi.org/10.1097/ALN.0b013e3181cded07.eng
dcterms.referencesHunter JM. Rocuronium: the newest aminosteroid neuromuscular blocking drug. Br J Anaesth 1996;76:481–3. https://doi.org/10.1093/bja/76.4.481.eng
dcterms.referencesWastila WB, Maehr RB, Turner GL, Hill DA, Phil. M, Savarese JJ. Comparative Pharmacology of Cisatracurium (51W89), Atracurium, and Five Isomers in Cats. Anesthesiology 1996;85:169–77. https://doi.org/10.1097/00000542-199607000-00023.eng
dcterms.referencesLu I-C, Tan H, Wu S-H, Huang T-Y, Tseng H-Y, Wang J-J, et al. A comparison between cisatracurium and rocuronium-induced neuromuscular block on laryngeal electromyography recovery after neostigmine reversal in a porcine model. Front Endocrinol (Lausanne) 2022;13. https://doi.org/10.3389/fendo.2022.875597.eng
dcterms.referencesLi G, Freundlich RE, Gupta RK, Hayhurst CJ, Le CH, Martin BJ, et al. Postoperative Pulmonary Complications’ Association with Sugammadex versus Neostigmine: A Retrospective Registry Analysis. Anesthesiology 2021;134:862–73. https://doi.org/10.1097/ALN.0000000000003735.eng
dcterms.referencesCarron M, Zarantonello F, Tellaroli P, Ori C. Efficacy and safety of sugammadex compared to neostigmine for reversal of neuromuscular blockade: a meta-analysis of randomized controlled trials. J Clin Anesth 2016;35:1–12. https://doi.org/10.1016/j.jclinane.2016.06.018.eng
dcterms.referencesTodd MM, Hindman BJ, King BJ. The Implementation of Quantitative Electromyographic Neuromuscular Monitoring in an Academic Anesthesia Department. Anesth Analg 2014;119:323–31. https://doi.org/10.1213/ANE.0000000000000261.eng
dcterms.referencesFuchs‐Buder T, Claudius C, Skovgaard LT, Eriksson LI, Mirakhur RK, Viby‐ Mogensen J. Good clinical research practice in pharmacodynamic studies of neuromuscular blocking agents II: the Stockholm revision. Acta Anaesthesiol Scand 2007;51:789–808. https://doi.org/10.1111/j.1399-6576.2007.01352.x.eng
oaire.versioninfo:eu-repo/semantics/acceptedVersion
sb.programaEspecialización en Anestesiologíaspa
sb.sedeSede Barranquillaspa

Archivos

Bloque original
Mostrando 1 - 2 de 2
No hay miniatura disponible
Nombre:
Resumen.pdf
Tamaño:
235.93 KB
Formato:
Adobe Portable Document Format
No hay miniatura disponible
Nombre:
PDF.pdf
Tamaño:
1.36 MB
Formato:
Adobe Portable Document Format
Bloque de licencias
Mostrando 1 - 1 de 1
No hay miniatura disponible
Nombre:
license.txt
Tamaño:
2.93 KB
Formato:
Item-specific license agreed upon to submission
Descripción:

Colecciones