08 March 2023: Human Study
Study of 60 Adult Patients to Compare Standard Postoperative Clinical Assessment with Train-of-Four Ratio ≥0.9 on Patient Outcomes Using Postoperative Spirometry and Neuromuscular Function Measurements Following Extubation
Chunlong Chen AEF , Qingzhen Liu CD , Hong Fan BD , Zhiyang Yu CF , Xueyan Leng B , Lidong Zhang ADF , Zhiqiang Zhou ADE*DOI: 10.12659/MSMBR.938849
Med Sci Monit Basic Res 2023; 29:e938849
Table 3 Strength measurements following extubation and adverse events.
| Clinical assessment group n=30 | TOF group n=30 | Clinical assessment group vs TOF group | ||
|---|---|---|---|---|
| Medians/means | Medians/means | Effect size (95% CI) | P value | |
| Incentive spirometer volume, mL | 0.252 | |||
| Baseline | 2812 (814) | 2975 (862) | −163 (−604 to 278) | 0.462 |
| @10 min | 1800 (913) | 1529 (718) | 271 (−161 to 703) | 0.214 |
| @30 min | 1883 (860) | 1788 (686) | 95 (−314 to 504) | 0.644 |
| @50 min | 2011 (826) | 1925 (676) | 87 (−310 to 484) | 0.664 |
| @24 h | 2699 (796) | 2823 (882) | −124 (−566 to 318) | 0.575 |
| Grip strength, kg | ||||
| Baseline | 21.6 [18.6–31.3] | 26.1 [19.7–30.9] | −1.5 (−9.4 to 2.8) | 0.469 |
| @10 min | 15.1 [11.6–22.2] | 12.8 [8.6–16.8] | 3.0 (−0.8 to 7.6) | 0.135 |
| @30 min | 20.6 [11.4–26.9] | 16.7 [14.6–24.1] | −0.1 (−5.3 to 5.2) | 0.958 |
| @50 min | 22.2 [12.6–30.2] | 21.2 [17.2–27.9] | −0.2 (−6.6 to 5.4) | 0.918 |
| @24 h | 22.5 [17.8–31.5] | 23.6 [20.2–30.8] | −1.0 (−5.6 to 3.7) | 0.636 |
| Ability to sit up | ||||
| Baseline | 30 (100%) | 30 (100%) | ||
| @10 min | 4 (13.3%) | 6 (20%) | 0. 7 (0.2 to 2.1) | 0.731 |
| @30 min | 13 (43.3%) | 16 (53.3%) | 0.8 (0.5 to 1.4) | 0.438 |
| @50 min | 27 (90%) | 23 (76.7%) | 1.2 (0.9 to 1.5) | 0.299 |
| @24 h | 30 (100%) | 29 (96.7%) | 1.0 (0.9 to 1.1) | 1 |
| TOFR at extubation | 0.87 [0.52–0.96] | 0.94 [0.92–0.97] | −7 (−18 to 0) | * |
| TOFR | 15 (50%) | 0 (0%) | 0.5 (0.4 to 0.7) | * |
| TOFR | 10 (33.3%) | 0 (0%) | 0.7 (0.5 to 0.9) | * |
| Body temperature, °C | 36.4 [36.3–36.5] | 36.5 [36.3–36.5] | 0.1 (−0.1 to 0.2) | 0.19 |
| RASS score 24 h | 0 [0–0] | 0 [0–0] | 0 (0 to 0) | 0.537 |
| Hypoxia | 9 (30) | 1 (3.3) | 12.4 (1.5 to105.7) | * |
| Tactile stimulation | 4 (13.3) | 1 (3.3) | 0.22 (0.02 to2.14) | 0.353 |
| Chin lift | 5 (16.7) | 0 (0) | 0.8 (0.7 to 0.9) | 0.052 |
| Re-intubation | 0 | 0 | ||
| Normally distributed continuous variables are presented as mean (SD), and effect size is presented as the difference in means (95% CI). Non-normally distributed continuous variables are presented as medians [IQR], and effect size is presented as a bootstrapped difference in medians (bootstrapped 95% CI). Categorical variables are presented as n (%), and effect size is presented as relative risk (95% CI). CI – confidence interval; IQR – interquartile range; PACU – Postanesthesia Care Unit; SD – standard deviation; TOFR – train-of-four ratio, which is calculated by comparing the magnitude of the fourth twitch to the first one and indicates a non-depolarizing neuromuscular block, and a ratio ≥0.90 can be used as an objective measurement of neuromuscular reversal. @10 min – time point of 10 min after extubation; @30 min – time point of 30 min after extubation; @50 min – time point of 50 min after extubation; @24 h – time point of 24 h after extubation. n – number; RASS – Richman Agitation Sedation Scale. * | ||||