{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T03:43:50Z","timestamp":1767066230821,"version":"build-2065373602"},"reference-count":55,"publisher":"Akademiai Kiado Zrt.","issue":"15","license":[{"start":{"date-parts":[[2025,4,13]],"date-time":"2025-04-13T00:00:00Z","timestamp":1744502400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["akjournals.com"],"crossmark-restriction":true},"short-container-title":["OH"],"published-print":{"date-parts":[[2025,4,13]]},"abstract":"<jats:p>Az izomrelax\u00e1nsok nem megfelel\u0151 haszn\u00e1lat\u00e1b\u00f3l ad\u00f3d\u00f3 posztoperat\u00edv residualis\n                    neuromuscularis blokk (PORNB) napjainkban tov\u00e1bbra is jelent\u0151s probl\u00e9ma, amely a\n                    posztoperat\u00edv pulmonalis sz\u00f6v\u0151dm\u00e9nyek \u00f6n\u00e1ll\u00f3 kock\u00e1zati t\u00e9nyez\u0151je. Ennek\n                    cs\u00f6kkent\u00e9se \u00e9rdek\u00e9ben 2023-ban az Eur\u00f3pai Aneszteziol\u00f3giai \u00e9s Intenz\u00edv Ter\u00e1pi\u00e1s\n                    T\u00e1rsas\u00e1g \u00e9s az Amerikai Aneszteziol\u00f3giai T\u00e1rsas\u00e1g megjelentette ir\u00e1nyelveit az\n                    izomrelax\u00e1nsok biztons\u00e1gos haszn\u00e1lat\u00e1t illet\u0151en. Ebben a k\u00f6zlem\u00e9nyben a\n                    Debreceni Egyetem Klinikai K\u00f6zpontja Aneszteziol\u00f3giai \u00e9s Intenz\u00edv Ter\u00e1pi\u00e1s\n                    Tansz\u00e9k\u00e9nek Tassonyi Ed\u00f6m\u00e9r Neuromuszkul\u00e1ris Munkacsoportja fogalmazza meg\n                    aj\u00e1nl\u00e1sait a t\u00e9m\u00e1ban. A nemzetk\u00f6zi aj\u00e1nl\u00e1sok alapj\u00e1n minden betegn\u00e9l, aki a\n                    m\u0171t\u00e9t sor\u00e1n nem depolariz\u00e1l\u00f3 izomrelax\u00e1nst kap, objekt\u00edv neuromuscularis\n                    monitoroz\u00e1st kell v\u00e9gezni. Mivel a m\u0171t\u00e9tek ut\u00e1n fenn\u00e1ll\u00f3 marad\u00e9k\n                    izomrelax\u00e1ns-hat\u00e1s sz\u00e1mos sz\u00f6v\u0151dm\u00e9ny forr\u00e1sa lehet, a betegbiztons\u00e1g\n                    szempontj\u00e1b\u00f3l kiemelten fontos, hogy az extub\u00e1l\u00e1st megel\u0151z\u0151en meggy\u0151z\u0151dj\u00fcnk\n                    arr\u00f3l, hogy az izomrelax\u00e1ns-hat\u00e1s megsz\u0171nt, \u00e9s a \u2019train-of-four\u2019 (TOF) ar\u00e1ny\n                    visszat\u00e9rt legal\u00e1bb 0,9-re (90%). A klinikai jelek vizsg\u00e1lata \u00e9s a szubjekt\u00edv\n                    monitoroz\u00e1s nem alkalmas a m\u0171t\u00e9t v\u00e9g\u00e9n fenn\u00e1ll\u00f3 marad\u00e9k izomrelax\u00e1ns-hat\u00e1s\n                    diagnosztiz\u00e1l\u00e1s\u00e1ra. Ez\u00e9rt minden esetben, ha a beteg nem depolariz\u00e1l\u00f3\n                    izomrelax\u00e1nst kap, objekt\u00edv neuromuscularis monitoroz\u00e1st kell v\u00e9gezni \u00e9s azzal\n                    igazolni, hogy nem \u00e1ll fenn PORNB. A neuromuscularis monitoroz\u00e1st lehet\u0151s\u00e9g\n                    szerint a k\u00e9zen kell v\u00e9gezni. Az objekt\u00edv monitoroz\u00e1st az izomrelax\u00e1ns bead\u00e1s\u00e1t\n                    megel\u0151z\u0151en kell ind\u00edtani a k\u00e9sz\u00fcl\u00e9k kalibr\u00e1ci\u00f3j\u00e1val. Az intub\u00e1l\u00e1s el\u0151tt meg kell\n                    v\u00e1rni, hogy a TOF-sz\u00e1m 0-ra cs\u00f6kkenjen (elt\u0171nj\u00f6n az izomv\u00e1lasz), mert a\n                    legink\u00e1bb \u00edgy biztos\u00edthat\u00f3k az ide\u00e1lis intub\u00e1l\u00e1si felt\u00e9telek, \u00e9s el\u0151zhet\u0151k meg\n                    az intub\u00e1l\u00e1sb\u00f3l ad\u00f3d\u00f3 l\u00e9g\u00fati s\u00e9r\u00fcl\u00e9sek. A m\u0171t\u00e9tek sor\u00e1n a TOF-m\u00e9r\u00e9seket\n                    rendszeres id\u0151k\u00f6z\u00f6nk\u00e9nt ism\u00e9telni sz\u00fcks\u00e9ges, az izomrelax\u00e1nsok hat\u00e1s\u00e1t\n                    folyamatosan nyomon kell k\u00f6vetni. A felf\u00fcggeszt\u0151szerek (mind a neosztigmin, mind\n                    a szugammadex) hat\u00e1s\u00e1t minden esetben objekt\u00edven monitorozni sz\u00fcks\u00e9ges. A\n                    benzil-izokinolin-v\u00e1zas relax\u00e1nsok hat\u00e1sa csak neosztigminnel antagoniz\u00e1lhat\u00f3,\n                    amennyiben a TOF-ingerl\u00e9sre m\u00e1r kapunk izomv\u00e1laszt A szteroidv\u00e1zas\n                    izomrelax\u00e1nsok (rokur\u00f3nium, vekur\u00f3nium, pipekur\u00f3nium) felf\u00fcggeszt\u00e9s\u00e9re a\n                    leghat\u00e9konyabb \u00e1gens a szugammadex, de ha a TOF-ingerl\u00e9sre m\u00e1r van izomv\u00e1lasz,\n                    akkor neosztigmin is haszn\u00e1lhat\u00f3. Orv Hetil. 2025; 166(15): 569\u2013577.<\/jats:p>","DOI":"10.1556\/650.2025.33285","type":"journal-article","created":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T22:04:19Z","timestamp":1744668259000},"page":"569-577","update-policy":"https:\/\/doi.org\/10.1556\/policypage.crossmark.crossref.2","source":"Crossref","is-referenced-by-count":1,"title":["Aj\u00e1nl\u00e1s az izomrelax\u00e1nsok biztons\u00e1gos perioperat\u00edv haszn\u00e1lat\u00e1ra"],"prefix":"10.1556","volume":"166","author":[{"given":"R\u00e9ka","family":"Nemes","sequence":"first","affiliation":[{"name":"Debreceni Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Klinikai K\u00f6zpont, Aneszteziol\u00f3giai \u00e9s Intenz\u00edv Ter\u00e1pi\u00e1s Tansz\u00e9k, Tassonyi Ed\u00f6m\u00e9r Neuromaszkul\u00e1ris Munkacsoport Debrecen, Nagyerdei krt. 98., 4032 Magyarorsz\u00e1g"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrienn","family":"Pongr\u00e1cz","sequence":"additional","affiliation":[{"name":"Debreceni Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Klinikai K\u00f6zpont, Aneszteziol\u00f3giai \u00e9s Intenz\u00edv Ter\u00e1pi\u00e1s Tansz\u00e9k, Tassonyi Ed\u00f6m\u00e9r Neuromaszkul\u00e1ris Munkacsoport Debrecen, Nagyerdei krt. 98., 4032 Magyarorsz\u00e1g"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L\u00e1szl\u00f3","family":"Asztalos","sequence":"additional","affiliation":[{"name":"Debreceni Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Klinikai K\u00f6zpont, Aneszteziol\u00f3giai \u00e9s Intenz\u00edv Ter\u00e1pi\u00e1s Tansz\u00e9k, Tassonyi Ed\u00f6m\u00e9r Neuromaszkul\u00e1ris Munkacsoport Debrecen, Nagyerdei krt. 98., 4032 Magyarorsz\u00e1g"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gy\u00f6rgy","family":"Nagy","sequence":"additional","affiliation":[{"name":"Debreceni Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Klinikai K\u00f6zpont, Aneszteziol\u00f3giai \u00e9s Intenz\u00edv Ter\u00e1pi\u00e1s Tansz\u00e9k, Tassonyi Ed\u00f6m\u00e9r Neuromaszkul\u00e1ris Munkacsoport Debrecen, Nagyerdei krt. 98., 4032 Magyarorsz\u00e1g"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zolt\u00e1n","family":"Szab\u00f3-Ma\u00e1k","sequence":"additional","affiliation":[{"name":"Debreceni Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Klinikai K\u00f6zpont, Aneszteziol\u00f3giai \u00e9s Intenz\u00edv Ter\u00e1pi\u00e1s Tansz\u00e9k, Tassonyi Ed\u00f6m\u00e9r Neuromaszkul\u00e1ris Munkacsoport Debrecen, Nagyerdei krt. 98., 4032 Magyarorsz\u00e1g"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marianna","family":"Fedor","sequence":"additional","affiliation":[{"name":"Debreceni Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Klinikai K\u00f6zpont, Aneszteziol\u00f3giai \u00e9s Intenz\u00edv Ter\u00e1pi\u00e1s Tansz\u00e9k, Tassonyi Ed\u00f6m\u00e9r Neuromaszkul\u00e1ris Munkacsoport Debrecen, Nagyerdei krt. 98., 4032 Magyarorsz\u00e1g"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B\u00e9la","family":"F\u00fclesdi","sequence":"additional","affiliation":[{"name":"Debreceni Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Klinikai K\u00f6zpont, Aneszteziol\u00f3giai \u00e9s Intenz\u00edv Ter\u00e1pi\u00e1s Tansz\u00e9k, Tassonyi Ed\u00f6m\u00e9r Neuromaszkul\u00e1ris Munkacsoport Debrecen, Nagyerdei krt. 98., 4032 Magyarorsz\u00e1g"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"425","reference":[{"key":"ref0","doi-asserted-by":"publisher","first-page":"1042","DOI":"10.1097\/00000542-200305000-00004","article-title":"Residual paralysis in the PACU after a single intubating dose of nondepolarizing muscle relaxant with an intermediate duration of action","volume":"98","author":"1 Debaene","year":"2003","unstructured":"1 Debaene B, Plaud B, Dilly MP, et al. 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