Simple Grip Strength Device For Assessing The Degree Of Recovery From Residual Neuromuscular Blockade After General Anaesthesia:An Observational Study

Objective:Neuromuscular monitors were used to monitor the change of train-of-four(TOF)rations during neuromuscular block recovery,and the preoperative basal grip strength values were measured using a simple grip strength device,and the corresponding percentage of grip strength recovery was compared with the corresponding grasp strength recovery percentage when the TOF ration was monitored by the neuromuscular monitor at 70%,80%and 90%,and the degree of neuromuscular block recovery was roughly assessed using simple grip strength measurement.Methods:Seventy-six patients undergoing elective general anaesthesia from November2021 to June 2022,aged 18-70 years,with American Society of Anesthesiologists physical status(ASA)classification of grade I-II were selected.Patients’gender,age,Body Mass Index(BMI),ASA classification,types and doses of neuromuscular blockers,total duration of surgery,Postanesthesia care unit(PACU)stay,preoperative basal grip strength values were recorded using a simple grip strength device,while the corresponding grip strength values at TOF ration of 70%,80%and 90%were monitored using a neuromuscular monitor.Spearman’s correlation analysis was used to analyse the correlation between the baseline percentage of grip strength recovery and neuromuscular monitor values to determine whether the simple grip device could be used as a crude assessment of the degree of neuromuscular blockade recovery.Results:1.General characteristics and measurements of the patient.Age,weight,BMI,sex,total time to surgery,total length of stay in PACU,and preoperative basal grip strength values of all patients,data expressed as mean±standard deviation.2.There was a significant correlation between the percentage of grip strength recovery measured by the simple grip device and the TOF ration during the recovery period of general anesthesia(R~2=0.632).3.Analysis of the relationship between the percentage of grip strength recovery and TOF ration in patients using different neuromuscular blocking agents.There was no significant difference in the preoperative maximum grip strength between the two groups using rocuronium and cis-atracurium(P>0.05).There was no significant difference in the mean percentage of maximum grip strength recovery between the two groups when the TOF ration was the same(P>0.05).There were no significant differences between the two groups in the total time of surgery(P=0.489)and the total time spent in PACU(P=0.202).Using regression analysis of percentage recovery of grip strength and TOF rations in patients with rocuronium,the coefficients of determination R~2=0.592,P<0.001.Regression analysis using cis-atracurium patients with percent recovery of grip strength and TOF rations,R~2=0.673,P<0.001.4.Analysis of percentage recovery of grip strength and TOF ration recovery in patients of different genders.There were significant differences in preoperative basal grip strength values(P<0.001)between genders,but there were no significant differences in the mean percentage of maximum grip strength recovery and total time spent in PACU at TOF rations of 70%,80%and 90%(P>0.05).Conclusions:In this study,we found a clear correlation between the percentage recovery of grip strength measured by this simple grip strength device and the TOF ration measured by quantitative neuromuscular monitoring,which can be used as an additional strategy to roughly estimate the degree of neuromuscular block recovery.