Surgical Muscle Relaxation

In Anesthesia practice neuromuscular blocking agents (muscle relaxants) areused for intubation and surgical muscle relaxation. The use of modern inhalational anestheticslike sevoflurane is commonly practiced in paediatric anesthesia for induction and endotrachealintubation. LMA (Laryngeal Mask Airway) is alternative to endotracheal intubation. It iscommonly used supraglotic device for the elective surgical procedures in adults and paediatricpopulation. We conducted this study to see whether sevoflurane produces enough surgicalmuscle relaxation so that the use of neuromuscular blocking agents can be avoided. StudyDesign: Observational study. Setting: King Khalid Hospital (KSA). Period: April 2013 toFebruary 2014. Material and Methods: 84 paediatric patients posted for elective surgicalprocedure were included. Regarding the adequacy of surgical muscle relaxation. Induction ofanesthesia was done with propofol 2mg/kg and Fentanyl 2 mcg/kg. Airway was maintained withLMA. Anesthesia was maintained by sevoflurane in oxygen and air. Blood pressure and Heartrate was kept with 20 % of baseline reading. Adequacy of surgical muscle relaxation was askedby the surgeon during surgery and was graded as good, fair or poor. Results: Mean age of thepatients was 2.4 year. There were 76 male and 8 female patients. 47 patients were operatedfor inguinal herniotomy, 32 for orchedopexy and 5 for umbilical herniotomy. Surgical musclerelaxation was good in all of the patients and none of them required use of muscle relaxants.Recovery of all patients was smooth. Discussion: Adequate surgical muscle relaxation isimportant to facilitate surgery. In paediatric population sevoflurane produces enough musclerelaxation for intubation and surgical muscle relaxation. Monitoring of muscle relaxation can beclinical as well as through muscle twitches. Conclusion: Our study showed that in paediatricpopulation