Assessment of Residual Paralysis in Patients Who Receive Mini-dose Atracurium During Supraglottic Airway Insertion

Post-operative residual paralysis may be defined as the incomplete recovery of muscle function following intra-operative administration of neuromuscular blockers (NMBs). This condition is associated with many negative patient outcomes such as: increased risk of aspiration; upper airway obstruction; and delayed Post-Anaesthetic Care Unit (PACU) discharge, amongst others. Despite the increasing use of shorter acting agents, the prevalence of residual paralysis in the PACU remains high at 20-50%. NMBs are commonly used to facilitate endotracheal intubation and insertion of the supraglottic airway by obtunding airway reflexes. Given the increasing use of mini-dose NMBs without post-operative reversal in clinical practice, there is a need to evaluate the incidence of residual paralysis in the patient population who have received mini-dose atracurium during the supraglottic airway insertion.

Inclusion criteria

• Adults above 21 years old
• Received either a mini-dose of atracurium or full dose of atracurium during the placement of the supraglottic airway
• Did not receive any neuromuscular reversal agent at any point of the operation.

Exclusion criteria

• Patients with underlying neuromuscular disease
• Patients who received pre-operative medication that may affect neuromuscular transmission
• Patients who required additional doses of neuromuscular blockade at any point of the operation