• B Debaene, A d'Hollander, B Plaud, E Samain, D Sirieix, C Baillard, and G Gehan.
• Service d'anesthésiologie, hôpital universitaire Cantonal, Genève, Suisse. dhollanderalain@yahoo.fr
• Ann Fr Anesth Reanim. 2011 Nov 1;30(11):795-803.

ObjectivesTo report any item documenting the peroperative muscle relaxant effects management in anaesthesia files issued from visceral surgery processes.Type Of StudyProspective, observational and multicenter.Patients And MethodsA single operator analysed 1453 files proposed by nine anaesthetists' teams. The items selected concerned three periods: induction/tracheal intubation, paralysis maintenance, tracheal extubation. Reporting of 40 categories of items was studied.ResultsItems related to laryngoscopy and intubation conditions were observed in 43% (0-95) [general average (intercentres min-max)] and in 11% (0-97) of the files, respectively. At least one level of paralysis was reported in 23% (0-96) of the files. For the paralysis maintenance, documentation of an effect appeared in 53% (4-96) of the documents. Neuromuscular assessments preceding the tracheal extubation were retrieved in 43% (12-89) of the notes. Adductor pollicis was concerned for 30% (1-89) of these observations. Detection of level of spontaneous paralysis offset, satisfying to the local standard, appeared in 14% (3-19) of the documents. Pharmacological reversal was noted for 25% (4-67) of the patients; the assessment of the effects so produced was reported in 8% (0-58).ConclusionIn the studied collection, the traceability of the peranaesthetic curarization management appears variable on both qualitative and quantitative levels. The emergence of a dedicated guideline - defining the criteria for producing a good documentation of the muscle relaxant use - becomes necessary to secure these practices for all physicians using muscle relaxants.Copyright © 2011 Elsevier Masson SAS. All rights reserved.

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