• Santos Filipe Nadir Caparica FNC Universidade Estadual de Campinas (Unicamp), Hospital da Mulher Prof. Dr. José Aristodemo Pinotti (CAISM), Campinas, SP, Brasil. Electron, Angelica de Fátima de Assunção Braga, Carla Josefine Barbosa de Lima Ribeiro, Braga Franklin Sarmento da Silva FSDS Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas, Departamento de Anestesiologia, Campinas, SP, Brasil., Vanessa Henriques Carvalho, and Fernando Eduardo Feres Junqueira.
• Universidade Estadual de Campinas (Unicamp), Hospital da Mulher Prof. Dr. José Aristodemo Pinotti (CAISM), Campinas, SP, Brasil. Electronic address: danest@fcm.unicamp.br.
• Rev Bras Anestesiol. 2017 Nov 1; 67 (6): 592-599.

ObjectiveEvaluate the incidence of postoperative residual curarization (PORC) in the post-anesthesia care unit (PACU) after the use of protocol and absence of intraoperative acceleromyography (AMG).MethodsRandomized clinical trial with 122 patients allocated into two groups (protocol and control). Protocol group received initial and additional doses of rocuronium (0.6mg.kg-1 and 10mg, respectively); the use of rocuronium was avoided in the final 45minutes; blockade reversal with neostigmine (50μg.kg-1); time ≥ 15minutes between reversion and extubation.Controlinitial and additional doses of rocuronium, blockade reversal, neostigmine dose, and extubation time, all at the discretion of the anesthesiologist. AMG was used in the PACU and PORC considered at T4/T1 ratio<1.0.ResultsThe incidence of PORC was lower in protocol group than in control group (25% vs. 45.2%, p=0.02). In control group, total dose of rocuronium was higher in patients with PORC than without PORC (0.43 vs. 0.35mg.kg-1.h-1, p=0.03) and the time interval between the last administration of rocuronium and neostigmine was lower (75.0 vs. 101.0min, p<0.01). In protocol group, there was no difference regarding the analyzed parameters (with PORC vs. without PORC). Considering the entire study population and the presence or absence of PORC, total dose of rocuronium was higher in patients with PORC (0.42 vs. 0.31mg.kg-1.h-1, p=0.01), while the time interval between the last administration of rocuronium and neostigmine was lower (72.5 vs. 99.0min, p ≤ 0.01).ConclusionThe proposed systematization reduced PORC incidence in PACU in the absence of intraoperative AMG.Copyright © 2017. Publicado por Elsevier Editora Ltda.

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