Does the objective measurement of muscle strength improve the detection of postoperative residual muscle weakness?

Background and Aims: The postoperative residual neuromuscular block (PRNB) has a significant impact on patient safety and well-being, but continues to remain underestimated. Objective evaluation of handgrip strength using a force dynamometer can be useful to identify postoperative muscle weakness. M...

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Main Authors: Durga Padmaja, Geetha Singam, Rabbani Tappa, Krishnarao Maremanda, Nitesh Kabra, Anupama Barada
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2024-01-01
Series:Journal of Anaesthesiology Clinical Pharmacology
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Online Access:https://journals.lww.com/10.4103/joacp.joacp_186_22
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author Durga Padmaja
Geetha Singam
Rabbani Tappa
Krishnarao Maremanda
Nitesh Kabra
Anupama Barada
author_facet Durga Padmaja
Geetha Singam
Rabbani Tappa
Krishnarao Maremanda
Nitesh Kabra
Anupama Barada
author_sort Durga Padmaja
collection DOAJ
description Background and Aims: The postoperative residual neuromuscular block (PRNB) has a significant impact on patient safety and well-being, but continues to remain underestimated. Objective evaluation of handgrip strength using a force dynamometer can be useful to identify postoperative muscle weakness. Material and Methods: Thirty-two American Society of Anesthesiologists (ASA) class I and II patients who received general anesthesia were included. Patients were extubated after the train-of-four (TOR) ratio (TOFR) was >0.90 and the clinical criteria for motor power recovery were judged as adequate. The measurements of handgrip strength and peak expiratory flow rate (PEFR) were obtained at baseline, 15 min after extubation, and 1, 2, and 4 h postoperatively. The incidence of significant decline from baseline (>25%) was determined. The correlation between handgrip strength and PEFR was assessed using Spearman correlation. The time to return to baseline for muscle grip strength and PEFR was performed using Kaplan–Meier survival analysis. A P value of 0.05 was considered significant for all tests. Results: The incidence of the significant decline in handgrip strength from baseline was 100% at 15 and 60 min, 76% at 2 h, and 9.4% at 4 h. There was a strong correlation between muscle grip strength and PEFR (0.89, P < 0.001). None of the patients exhibited the potential complications of PRNB. (PRMB in abstract. It should be uniform) The mean time to return to the baseline value of muscle grip strength was 3.8 h (95% confidence interval [CI] 3.6–3.9), and the mean time to return to baseline for PEFR was 3.2 h (95% CI 2.9–3.4 h). Conclusion: Objective assessment of muscle grip strength using a force dynamometer has the potential to be a new objective metric to monitor postoperative muscle weakness.
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spelling doaj-art-e8d37686b84b40ec8302e0625e1157172024-12-17T06:57:12ZengWolters Kluwer Medknow PublicationsJournal of Anaesthesiology Clinical Pharmacology0970-91852024-01-01401293610.4103/joacp.joacp_186_22Does the objective measurement of muscle strength improve the detection of postoperative residual muscle weakness?Durga PadmajaGeetha SingamRabbani TappaKrishnarao MaremandaNitesh KabraAnupama BaradaBackground and Aims: The postoperative residual neuromuscular block (PRNB) has a significant impact on patient safety and well-being, but continues to remain underestimated. Objective evaluation of handgrip strength using a force dynamometer can be useful to identify postoperative muscle weakness. Material and Methods: Thirty-two American Society of Anesthesiologists (ASA) class I and II patients who received general anesthesia were included. Patients were extubated after the train-of-four (TOR) ratio (TOFR) was >0.90 and the clinical criteria for motor power recovery were judged as adequate. The measurements of handgrip strength and peak expiratory flow rate (PEFR) were obtained at baseline, 15 min after extubation, and 1, 2, and 4 h postoperatively. The incidence of significant decline from baseline (>25%) was determined. The correlation between handgrip strength and PEFR was assessed using Spearman correlation. The time to return to baseline for muscle grip strength and PEFR was performed using Kaplan–Meier survival analysis. A P value of 0.05 was considered significant for all tests. Results: The incidence of the significant decline in handgrip strength from baseline was 100% at 15 and 60 min, 76% at 2 h, and 9.4% at 4 h. There was a strong correlation between muscle grip strength and PEFR (0.89, P < 0.001). None of the patients exhibited the potential complications of PRNB. (PRMB in abstract. It should be uniform) The mean time to return to the baseline value of muscle grip strength was 3.8 h (95% confidence interval [CI] 3.6–3.9), and the mean time to return to baseline for PEFR was 3.2 h (95% CI 2.9–3.4 h). Conclusion: Objective assessment of muscle grip strength using a force dynamometer has the potential to be a new objective metric to monitor postoperative muscle weakness.https://journals.lww.com/10.4103/joacp.joacp_186_22extubationforce dynamometerhandgrip strengthobjectivepeak expiratory flow ratetrain of four
spellingShingle Durga Padmaja
Geetha Singam
Rabbani Tappa
Krishnarao Maremanda
Nitesh Kabra
Anupama Barada
Does the objective measurement of muscle strength improve the detection of postoperative residual muscle weakness?
Journal of Anaesthesiology Clinical Pharmacology
extubation
force dynamometer
handgrip strength
objective
peak expiratory flow rate
train of four
title Does the objective measurement of muscle strength improve the detection of postoperative residual muscle weakness?
title_full Does the objective measurement of muscle strength improve the detection of postoperative residual muscle weakness?
title_fullStr Does the objective measurement of muscle strength improve the detection of postoperative residual muscle weakness?
title_full_unstemmed Does the objective measurement of muscle strength improve the detection of postoperative residual muscle weakness?
title_short Does the objective measurement of muscle strength improve the detection of postoperative residual muscle weakness?
title_sort does the objective measurement of muscle strength improve the detection of postoperative residual muscle weakness
topic extubation
force dynamometer
handgrip strength
objective
peak expiratory flow rate
train of four
url https://journals.lww.com/10.4103/joacp.joacp_186_22
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AT rabbanitappa doestheobjectivemeasurementofmusclestrengthimprovethedetectionofpostoperativeresidualmuscleweakness
AT krishnaraomaremanda doestheobjectivemeasurementofmusclestrengthimprovethedetectionofpostoperativeresidualmuscleweakness
AT niteshkabra doestheobjectivemeasurementofmusclestrengthimprovethedetectionofpostoperativeresidualmuscleweakness
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