Comparison Of Diaphragmatic Excursion And Diaphragmatic Thickening Fraction As Ultrasound Markers For Assessing Post Operative Residual Curarization

Postoperative residual curarization (PORC), defined as a train-of-four (TOF) ratio less 0.9, is associated with postoperative respiratory complications such as hypoxia, airway obstruction, and impaired airway reflexes. Although TOF monitoring is considered the gold standard for assessing recovery from neuromuscular blockade, its use may have practical limitations. Diaphragm ultrasonography is a non-invasive bedside modality that can assess diaphragmatic function using parameters such as diaphragmatic excursion (DE) and diaphragmatic thickening fraction (DTF).

This prospective observational study will include 70 adult patients undergoing elective surgery under general anaesthesia with non-depolarizing neuromuscular blocking agents. Diaphragmatic excursion and thickening fraction will be measured using ultrasonography at predefined perioperative time points and correlated with TOF ratios to evaluate their utility in detecting postoperative residual curarization.