Journal of clinical anesthesia
-
Complete reversal of neuromuscular blockade (NMB) is important for patient safety and prognosis following surgical procedures involving NMB agents (NMBAs). Published evidence on the epidemiology and consequences of residual neuromuscular blockade (rNMB; incomplete neuromuscular recovery) in real-world clinical settings is lacking with advances in NMB management. Therefore, we aimed to examine the burden of rNMB and its associated clinical, economic and humanistic outcomes using a systematic review framework. ⋯ Real-world observational studies show a significant burden of rNMB and associated health sequelae, though rNMB measures were not reported consistently across studies. Appropriate quantitative measurement is needed to accurately identify rNMB, and interventions are needed to reduce its burden and associated adverse outcomes.
-
To assess the risk for postoperative acute kidney injury (AKI) after major urologic surgery for different intraoperative hypotension thresholds in form of time below a fixed threshold. We hypothesize that the duration of hypotension below a certain hypotension threshold is a risk factor for AKI also in major urologic procedures. ⋯ Our results suggest that avoiding intraoperative MAP lower than 65 mmHg and especially lower than 60 mmHg will protect postoperative renal function in cystectomy patients. The time between induction of anesthesia and surgical incision warrants special attention as a relevant share of hypotension occur in this period.