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Related Experiment Video

Updated: Feb 11, 2026

Deep Neuromuscular Blockade Leads to a Larger Intraabdominal Volume During Laparoscopy
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Quantitative Relationships between Pulmonary Function and Residual Neuromuscular Blockade.

ShuYing Fu1,2,3, WenDong Lin1,2,4, XiNing Zhao1,2

  • 1Department of Anesthesia, Zhongshan Hospital, Fudan University, Shanghai 200032, China.

Biomed Research International
|April 18, 2018
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Summary
This summary is machine-generated.

Postoperative residual neuromuscular blockade is common and impairs pulmonary function recovery. Even with a train-of-four ratio (TOFR) of 0.90, lung function may not return to acceptable levels.

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Area of Science:

  • Anesthesiology
  • Respiratory Physiology
  • Postoperative Care

Background:

  • Residual neuromuscular blockade is a known risk factor for postoperative respiratory weakness.
  • Quantitative relationships between pulmonary function impairment and residual neuromuscular blockade are not well understood.

Purpose of the Study:

  • To investigate the quantitative relationship between pulmonary function recovery and residual neuromuscular blockade after laparoscopic cholecystectomy.
  • To determine acceptable thresholds for train-of-four ratio (TOFR) for adequate pulmonary function recovery.

Main Methods:

  • 113 patients undergoing elective laparoscopic cholecystectomy had preoperative pulmonary function tests (PFTs).
  • For 98 patients, train-of-four ratio (TOFR) and PFTs were measured in the postanesthesia care unit (PACU).
  • Analysis focused on PFT recovery at various TOFR levels.

Main Results:

  • Significant differences were observed between preoperative and postoperative forced vital capacity and peak expiratory flow at most TOFR points (P < 0.05).
  • These differences persisted even at higher TOFR values, indicating incomplete functional recovery.

Conclusions:

  • A high incidence (75.51%) of residual neuromuscular blockade was found after tracheal extubation.
  • Pulmonary function often fails to reach 85% of baseline, even when TOFR recovers to 0.90, highlighting the risk of persistent respiratory weakness.