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The Effect of Patient Weight and Provider Training and Experience on Dosing of Rocuronium

Introduction. Maintenance dosing of neuromuscular blocking agents is complex and varies with patient, procedure, and clinical situation. With this in mind, we sought to identify factors impacting the maintenance dosing of neuromuscular blockers as a step toward identifying best practice with respect...

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Autores principales: Godwin, N. C., Rodriguez, L., Banks, S., Major, B. T., Rodriguez, Y.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4939195/
https://www.ncbi.nlm.nih.gov/pubmed/27429615
http://dx.doi.org/10.1155/2016/3136895
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author Godwin, N. C.
Rodriguez, L.
Banks, S.
Major, B. T.
Rodriguez, Y.
author_facet Godwin, N. C.
Rodriguez, L.
Banks, S.
Major, B. T.
Rodriguez, Y.
author_sort Godwin, N. C.
collection PubMed
description Introduction. Maintenance dosing of neuromuscular blocking agents is complex and varies with patient, procedure, and clinical situation. With this in mind, we sought to identify factors impacting the maintenance dosing of neuromuscular blockers as a step toward identifying best practice with respect to minimizing residual neuromuscular blockade. Methods. Cases utilizing rocuronium from July 1, 2010, to June 30, 2014, at the sponsoring institution were analyzed. Using a mixed model to account for repeated measures, patients were analyzed by dose and weight category as defined by the World Health Organization (eight categories ranging from very severely underweight to very severely obese) as well as by the administering provider's level of experience. Results. The study included 12,671 patients with a mean age of 49.7 (SD 16.7). Increasing weight category and higher levels of provider experience were associated with higher doses for rocuronium. There were no differences in initial dose or in frequency of maintenance dosing by weight category after controlling for case length. Discussion. The two dosing patterns identified, higher doses for overweight patients and higher doses administered by experienced providers, are modifiable factors that could enhance patient safety.
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spelling pubmed-49391952016-07-17 The Effect of Patient Weight and Provider Training and Experience on Dosing of Rocuronium Godwin, N. C. Rodriguez, L. Banks, S. Major, B. T. Rodriguez, Y. Anesthesiol Res Pract Research Article Introduction. Maintenance dosing of neuromuscular blocking agents is complex and varies with patient, procedure, and clinical situation. With this in mind, we sought to identify factors impacting the maintenance dosing of neuromuscular blockers as a step toward identifying best practice with respect to minimizing residual neuromuscular blockade. Methods. Cases utilizing rocuronium from July 1, 2010, to June 30, 2014, at the sponsoring institution were analyzed. Using a mixed model to account for repeated measures, patients were analyzed by dose and weight category as defined by the World Health Organization (eight categories ranging from very severely underweight to very severely obese) as well as by the administering provider's level of experience. Results. The study included 12,671 patients with a mean age of 49.7 (SD 16.7). Increasing weight category and higher levels of provider experience were associated with higher doses for rocuronium. There were no differences in initial dose or in frequency of maintenance dosing by weight category after controlling for case length. Discussion. The two dosing patterns identified, higher doses for overweight patients and higher doses administered by experienced providers, are modifiable factors that could enhance patient safety. Hindawi Publishing Corporation 2016 2016-06-26 /pmc/articles/PMC4939195/ /pubmed/27429615 http://dx.doi.org/10.1155/2016/3136895 Text en Copyright © 2016 N. C. Godwin et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Godwin, N. C.
Rodriguez, L.
Banks, S.
Major, B. T.
Rodriguez, Y.
The Effect of Patient Weight and Provider Training and Experience on Dosing of Rocuronium
title The Effect of Patient Weight and Provider Training and Experience on Dosing of Rocuronium
title_full The Effect of Patient Weight and Provider Training and Experience on Dosing of Rocuronium
title_fullStr The Effect of Patient Weight and Provider Training and Experience on Dosing of Rocuronium
title_full_unstemmed The Effect of Patient Weight and Provider Training and Experience on Dosing of Rocuronium
title_short The Effect of Patient Weight and Provider Training and Experience on Dosing of Rocuronium
title_sort effect of patient weight and provider training and experience on dosing of rocuronium
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4939195/
https://www.ncbi.nlm.nih.gov/pubmed/27429615
http://dx.doi.org/10.1155/2016/3136895
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