When you have to care the patient with abnormal neuromuscular function, you have to consider about the fate of your patient when he/she is allowed to breathe by him/herself whether or not your patient can tolerate this test because this would mean safety of him.
On Friday 15 June 2555, we encountered a lady with the problem of muscle weakness for a decade, she has been treated with Pyridostigmine 180 mg/day, her presenting symptom at that time was the problem with the eyelids, however, she had never been hospitalised before, never been admitted due to respiratory failure.
With the application of neuromuscular monitoring we can attenuate the total dose of neuromuscular blocking agent (muscle relaxant) to nearly 15% of the total dose required by her based on her body weight and assumed that she would have normal muscle power. Therefore, she can have an uneventful perioperative course in the immediate postoperative period.
TOF is a mode commonly used to monitor the response of a muscle relaxant, normally it is quite all right to have a TOF count of 2 for an anaesthetic with administered relaxant. One thing to be kept in mind is the neuromuscular blocking agents are not anaesthetics, they would not help you with the analgesic or amnesic effects, not help deepen the anaesthetic depth, it is just an agent that makes your patient flaccid, cannot scream, cannot move, and fully awake.
No comments:
Post a Comment