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Korean Journal of Anesthesiology 2006;51(2):167-173.
DOI: https://doi.org/10.4097/kjae.2006.51.2.167   
The Influence of Patient Controlled Analgesia on the Recovery of Muscle Power and Respiratory Function following Intraoperative Muscle Relaxants.
Se Hwan Kim, Ok Sik Han, Hee Soong Jung, Doo Sik Kim, Sie Jeong Ryu, Tae Ho Chang, Kyung Han Kim
1Department of Anesthesiology and Pain Medicine, Kosin Medical College, Busan, Korea. kshwan@ns.kosinmed.or.kr
2Department of Anesthesiology and Pain Medicine, Wallace Memorial Baptist Hospital, Busan, Korea.
Abstract
BACKGROUND
Residual muscle paralysis after anesthesia is reduced with the advent of intermediate-acting neuromuscular blocking drugs, yet the incidence is as high as about 10 percent. Opioids in patient-controlled analgesia (PCA) may cause respiratory depression and other problems after anesthesia. The purpose of this study is to evaluate the influence of PCA on the SPO2, TOF ratio, head-lift and tongue protrusion during recovery room stay following intraoperative muscle relaxants.
METHODS
120 patients aged from 20 to 65 in ASA class I and II were divided into control or PCA groups. All patients received rocuronium (0.9 mg/kg) or atracurium (0.5 mg/kg) for tracheal intubation, and maintenance of relaxation was done with atracurium 0.2 mg/kg/hr during inhalation anesthesia. Reversal of block was done with pyridostigmine 0.15 mg/kg and glycopyrrolate 0.2 mg. SpO2, TOF ratio, 5 sec-head lift, tongue protrusion tests were evaluated in the recovery room.
RESULTS
IV-PCA did not influence the incidence of residual block, SPO2, TOF ratio during recovery room stay for 20 minutes, but influenced negatively 5 sec-head lift test, tongue protrusion test only immediately after arrival at the recovery room.
CONCLUSIONS
Since IV-PCA decreased the ability to perform head-lift and tongue protrusion early postoperatively, it is recommended that patients with IV-PCA should be carefully managed against the risk of aspiration or upper respiratory obstruction during their early recovery room stay.
Key Words: head-lift test; muscle relaxant; patient-controlled analgesia; SpO2; TOF ratio; tongue protrusion test


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