[The incidence of postoperative residual curarization in the recovery room after rocuronium administration]

In 513 patients, we investigated residual curarization after general anaesthesia with rocuronium administered, without peroperative neuromuscular blockade monitoring. On admission to the recovery room, the ulnar nerve was stimulated submaximally (30 mA) and the evoked muscle response was quantified with accelerometry (TOF-Watch SX, Organon). The postoperative residual curarization was defined as a TOF-ratio < 0.9 and could be demonstrated in 174 patients (34 %). Compared to the group with adequate recovery, these patients received larger rocuronium dose [45.4 (SD 13.2) mg vs. 40.4 (SD 14.3) mg, p < 0.01], less experienced anaesthesiologists conducted their case [p <0.01], shorter time had elapsed since the last rocuronium dose [58.4 (20.9) min. vs. 64.9 (27.2) min., p < 0.05], their core temperature was lower [35.4 (0.6) degrees C vs. 35.8 (0.6) degrees C, p < 0.011 and on average, they received less neostigmine during anaesthesia [0.26 (0.47) mg vs. 0.57 (0.71) mg, p < 0.01]. We conclude that it is necessary to antagonize residual block after rocuronium, especially in the absence of perioperative neuromuscular monitoring.