Relajación residual en la unidad de cuidado posanestésico

Residual relaxation in the posanesthetic care unit

El uso de relajantes neuromusculares en la práctica clínica es cada día más frecuente e indispensable en el acto anestésico y la unidad de cuidado intensivo. Aunque los bloqueantes neuromusculares tanto aminoesteroideos como benzilisoquinolinas de última generación tienen efectos adversos mínimos, la relajación residual es una complicación de incidencia considerable asociada con un incremento en la morbilidad y mortalidad. Debido a esto planteamos la importancia de conocer los diferentes métodos de monitoria del bloqueo neuromuscular con su interpretación, haciendo énfasis en la monitoria con el tren de cuatro (TOF), la razón entre la primera y la cuarta respuesta T4/T1 (TOF RATIO) y estrategias de prevención de la relajación residual. Abreviaturas: TOF, tren de cuatro; PORC, parálisis residual posoperatoria; RNMND, relajantes neuromusculares no despolarizantes; UCPA, unidad de cuidado posoperatorio.

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