Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

Improving neuromuscular monitoring and reducing residual neuromuscular blockade via e-learning: A multicentre interrupted time-series study (INVERT study)

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

  1. AHA STEROID trial, dexamethasone in acute high-risk abdominal surgery, the protocol for a randomized controlled trial

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Continuous monitoring of vital sign abnormalities; association to clinical complications in 500 postoperative patients

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Diagnostic criteria of CNS infection in patients with external ventricular drainage after traumatic brain injury: a pilot study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Development of a core outcome set for general intensive care unit patients - a protocol

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Continuing professional development for anesthesiologists: a systematic review protocol

    Publikation: Bidrag til tidsskriftReviewForskningpeer review

  2. Combining in-situ simulation and live HEMS mission facilitator observation: a flexible learning concept

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Live video from bystanders' smartphones to improve cardiopulmonary resuscitation

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Vis graf over relationer

BACKGROUND: Neuromuscular monitoring should be applied routinely to avoid residual neuromuscular block. However, anaesthetists often refrain from applying it, even when the equipment is available. We aimed to increase neuromuscular monitoring in six Danish anaesthesia departments via e-learning.

METHODS: Interrupted time series study, with baseline data from a previous study and prospective data collection after implementation of the module, which was available for 2 weeks from 21 November 2016. We included all patients receiving general anaesthesia with muscle relaxants until 30 April 2017. Main outcome was application of acceleromyography, grouped as succinylcholine only and non-depolarising relaxants. Secondary outcomes were last recorded train-of-four ratio (non-depolarising) relaxants and score on a ten-question pre- and post-course multiple-choice test.

RESULTS: The post-intervention data consisted of 6525 cases (3099 (48%) succinylcholine only, 3426 (52%) non-depolarising relaxants). Analysing all departments, we found a positive pre-intervention trend in application of acceleromyography for both groups, of estimated 7.5% and 4.8% per year, respectively (p < .001). The monitoring rate increased significantly for succinylcholine in two departments post-intervention (p = .045 and .010), and for non-depolarising relaxants in one department (p = .041), but followed by a negative trend of -37.0% per year (p = .041). The rate was already close to 90% at the time of the intervention and the mean last recorded train-of-four ratio was 0.97 (SD 0.21), also without a significant change. The median score on the post-course test increased from 7 (IQR 5-8) to 9 (IQR 8-10) (p < .001, Wilcoxon Signed-Ranks Test).

CONCLUSION: We found no overall effect of the e-learning module on application of neuromuscular monitoring, although the post-course test indicated an effect on anaesthetists' knowledge in this field.

TRIAL REGISTRATION: Trial registration: Clinicaltrials.gov identifier: NCT02925143. https://clinicaltrials.gov/ct2/show/NCT02925143.

OriginalsprogEngelsk
TidsskriftActa Anaesthesiologica Scandinavica
Vol/bind66
Udgave nummer5
Sider (fra-til)580-588
Antal sider9
ISSN0001-5172
DOI
StatusUdgivet - maj 2022

Bibliografisk note

© 2022 The Authors. Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.

ID: 74397173