viernes, 7 de agosto de 2015

Relajantes neurumusculares en pediatría/Neuromuscular block in infants

No. 2037                                                                                  Julio 28, 2015

Parálisis residual postoperatoria en un hospital infantil Australiano de tercer nivel
Postoperative Residual Neuromuscular Paralysis at an Australian Tertiary Children's Hospital.
Anesthesiol Res Pract. 2015;2015:410248. doi: 10.1155/2015/410248. Epub 2015 May 10.

Existe poca orientación profesional en la literatura para guiar el uso seguro del bloqueo neuromuscular en los infantes.
Limited professional guidance and literature are available to guide the safe use of neuromuscular block in infants.
Acta Paediatr. 2014 Sep;103(9):e370-3. doi: 10.1111/apa.12682. Epub 2014 Jun 20.
AIM: Neuromuscular blocking agents (NMBAs) are used in a range of critical illnesses in neonates and infants, despite a lack of guidelines and professional standards. This study reviewed the current evidence base and ascertained UK practice regarding the continuous use of these agents in this age range. METHODS: We reviewed the literature and carried out a telephone questionnaire of all tertiary units in England and specialist children's hospital neonatal units in the UK. RESULTS: No best practice guidelines or general consensus statements were found, and the only randomised trial to feature an NMBA protocol expressed concerns about its use in such young babies. Of the 56 units contacted, 54 (96.4%) shared information. Only three of the 56 (5.4%) used intermittent boluses of NMBAs, 91.1% used NMBA infusions, 11 (19.6%) routinely used regular neuromuscular blocker pause to assess depth, and only one (1.8%) used peripheral nerve stimulation monitoring. All the units carried out clinical assessments, but only one (1.8%) had a written protocol. CONCLUSION: There is a paucity of literature and professional standards to guide the safe use of NMBAs in infants. Of the 54 units who participated in the survey, only one had a protocol for using NMBAs in babies.
KEYWORDS: Critical care; Neonatology; Neuromuscular blockadeNeuromuscular monitoring; Pharmacology
Anestesia y Medicina del Dolor
Safe Anesthesia World Wide  

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