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...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2016-01-01
|
| Series: | Anesthesiology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2016/3136895 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832558551437934592 |
|---|---|
| author | N. C. Godwin L. Rodriguez S. Banks B. T. Major Y. Rodriguez |
| author_facet | N. C. Godwin L. Rodriguez S. Banks B. T. Major Y. Rodriguez |
| author_sort | N. C. Godwin |
| collection | DOAJ |
| 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. |
| format | Article |
| id | doaj-art-baca17b5d8ed4b47aefeb797a0ea61a0 |
| institution | Kabale University |
| issn | 1687-6962 1687-6970 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Anesthesiology Research and Practice |
| spelling | doaj-art-baca17b5d8ed4b47aefeb797a0ea61a02025-02-03T01:32:09ZengWileyAnesthesiology Research and Practice1687-69621687-69702016-01-01201610.1155/2016/31368953136895The Effect of Patient Weight and Provider Training and Experience on Dosing of RocuroniumN. C. Godwin0L. Rodriguez1S. Banks2B. T. Major3Y. Rodriguez4Department of Anesthesiology, Jackson Memorial Hospital/University of Miami, Miami, FL 33136, USADepartment of Anesthesiology, Jackson Memorial Hospital/University of Miami, Miami, FL 33136, USADepartment of Anesthesiology, Jackson Memorial Hospital/University of Miami, Miami, FL 33136, USADepartment of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USADepartment of Anesthesiology, Jackson Memorial Hospital/University of Miami, Miami, FL 33136, USAIntroduction. 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.http://dx.doi.org/10.1155/2016/3136895 |
| spellingShingle | N. C. Godwin L. Rodriguez S. Banks B. T. Major Y. Rodriguez The Effect of Patient Weight and Provider Training and Experience on Dosing of Rocuronium Anesthesiology Research and Practice |
| 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 |
| url | http://dx.doi.org/10.1155/2016/3136895 |
| work_keys_str_mv | AT ncgodwin theeffectofpatientweightandprovidertrainingandexperienceondosingofrocuronium AT lrodriguez theeffectofpatientweightandprovidertrainingandexperienceondosingofrocuronium AT sbanks theeffectofpatientweightandprovidertrainingandexperienceondosingofrocuronium AT btmajor theeffectofpatientweightandprovidertrainingandexperienceondosingofrocuronium AT yrodriguez theeffectofpatientweightandprovidertrainingandexperienceondosingofrocuronium AT ncgodwin effectofpatientweightandprovidertrainingandexperienceondosingofrocuronium AT lrodriguez effectofpatientweightandprovidertrainingandexperienceondosingofrocuronium AT sbanks effectofpatientweightandprovidertrainingandexperienceondosingofrocuronium AT btmajor effectofpatientweightandprovidertrainingandexperienceondosingofrocuronium AT yrodriguez effectofpatientweightandprovidertrainingandexperienceondosingofrocuronium |