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Volume 13 Issue 2 (February) 2024

Original Articles

Study of Intraoperative requirement of Inj. Atracurium (NMBA) with and without the use of neuromuscular monitoring in patients undergoing Laparoscopic Cholecystectomy
Dr. Sachin Asaram Devgude, Dr. Santosh Ratan Kalushe, Dr. Vivek Ravindra Gadhari, Dr. Dipti Kotwani

Background: Neuromuscular blocking agents (NMBA) are routinely administered during anaesthesia to facilitate endotracheal intubation and to provide good muscle relaxation for optimal surgical conditions. In most clinical settings, intubating time after administration of NMBA is determined by clinical feel of the patient (ease of ventilation, jaw and upper airway tone) or timeof onset of action of the NMBA. Literature recommends neuromuscular block should be monitored for all patients who receive NMBAs during anaesthesia, to guide appropriate NMBA dosing and appropriate timing for administration of reversal agents. Methodology-The above study was conducted on 70 patients undergoing elective laparoscopic cholecystectomy in operation theaters at Tertiary care hospital from November 2019 to September 2021. Patients were monitored and data was collected, analyzed and entered in the form of tables. Results- Frequency of mean Atracurium doses needed in the neuromuscular monitoring group was significantly much less than the clinical monitoring group (P <0.001). Mean interval for top-up dose of Atracurium was 26.87±6.68 minutes in the neuromuscular monitoring which was highly significant (p<0.001). The mean time from the last dose of Atracurium to the start of antagonism of the neuromuscular block agent in the neuromuscular monitoring group was highly significant (P<0.001). Conclusion- Quantitative neuromuscular monitoring (NMT) should be performed for all patients who receive NMBAs during general anaesthesia.

 
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