Change in the effect of rocuronium after pneumatic tourniquet release in patients undergoing unilateral total knee arthroplasty

다국어 초록 (Multilingual Abstract)

Background: A pneumatic tourniquet is commonly used inorthopedic surgery. However, neuromuscular blocking agent can besequestered in the isolated limb and be reabsorbed into the systemiccirculation after tourniquet release, potentially delaying extubation. To investigate the change in the train-of-four (TOF) ratio aftertourniquet release and correlate the TOF ratio change with theextubation time.
Methods: Forty patients undergoing unilateral total kneearthroplasty were enrolled. Before and after the pneumatictourniquet release, 10 measurements of the TOF ratio wereaveraged and compared. Additionally, we investigated thecorrelation between the percentage change in the TOF ratio beforeand after tourniquet release and the extubation time.
Results: Among the 40 patient subjects, 30 showed a TOF ratiobefore tourniquet release and 10 showed only a TOF count. Of the30 patients with a TOF ratio, 21 showed a TOF ratio increase aftertourniquet release and 9 showed a TOF decrease; both increaseand decrease were statistically significant (P ＜ 0.001 and P = 0.008,respectively). The extubation time showed a weak negativecorrelation with the percentage change in the TOF ratio aftertourniquet release (P = 0.004).
Conclusions: In orthopedic surgery using a pneumatic tourniquet,neuromuscular function monitoring may be required to monitor thechange in the effect of neuromuscular blocking agent before andafter tourniquet release, which may help to improve anesthesiasafety.

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