Postoperative Residual Curarization in Difficult Environment for the Practice of General Anesthesia: Inventory of the Yaounde/Essos Hospital Center

Author(s): Jemea B, Nga Nomo S, Iroume C, Djomo Tamchom D, Chewa G, Mouafo B, Nkoumou S, Ze Minkande J, Binam F

Background

Residual curarization is dangerous, it promotes postoperative pneumonia. The objective of this study was to assess the relevance of clinical extubation criteria in the prevention of residual curarization.

Patients and methods

This was a prospective and descriptive study carried out over a period of 3 months in the anesthesia department of the Yaounde-Essos hospital center. It included all adult patients operated on under general anesthesia for elective surgery, and who received vecuronium bromide administration during the anesthetic procedure.

Results

A total of 80 patients were collected from 150 acts of anesthesia performed during the study period. The average age was 44 years old, the sex ratio of 1.10 in favor of men. The patient's extubation was based in the majority of cases (82.6%) on the combination of the following clinical criteria: the presence of spontaneous ventilation and swallowing reflex, the positive head lift test and the level of correct consciousness. The incidence of postoperative residual curarization was 50%. The main complications were hypoventilation associated with hypoxia (40%), diplopia (35%) and apnea (25%).

Conclusion

The incidence of residual curarization remains high at the essos hospital centre. Reliable detection of curarization can only be done with a measuring instrument.