Incidence of postoperative residual neuromuscular blockade after general anesthesia: a prospective, multicenter, anesthetist-blind, observational study

Abstract

NCT01871064.

Train‐of‐four recovery precedes twitch recovery during reversal with sugammadex in pediatric patients: A retrospective analysis

“…In contrast, the recovery times to reach a TOF ratio equal or greater than 0.9 are more rapid after sugammadex compared with spontaneous recovery of neuromuscular blockade or after reversal with cholinesterase inhibitors. Hence, the reversal of a rocuronium‐induced neuromuscular blockade with sugammadex may prevent residual neuromuscular blockade which is shown in several studies . The results of our findings may not be clinically relevant regarding the risk of residual neuromuscular blockade and therefore theoretical only.…”

“…Hence, the reversal of a rocuronium-induced neuromuscular blockade with sugammadex may prevent residual neuromuscular blockade which is shown in several studies. 7,8,14 The results of our findings may not be clinically relevant regarding the risk of residual neuromuscular blockade and therefore theoretical only. However, no dedicated studies are performed to prove this statement.…”

Residual Neuromuscular Blockade in the Critical Care Setting

“…Therefore, complications associated with neuromuscular blockade are seen in patients older than 45 years, placing this population at an increased risk for residual paralysis. 6 Several factors contributing to residual paralysis in older patients are the administration of more than 2 paralytic medications, the duration of action of a chosen reversal agent, and extubation occurring less than 10 minutes after a reversal agent has been given. 6 Obstructive sleep apnea (OSA) and obesity contribute to pulmonary compromise, especially in the presence of RNMB.…”

“…6 Several factors contributing to residual paralysis in older patients are the administration of more than 2 paralytic medications, the duration of action of a chosen reversal agent, and extubation occurring less than 10 minutes after a reversal agent has been given. 6 Obstructive sleep apnea (OSA) and obesity contribute to pulmonary compromise, especially in the presence of RNMB. Obesity contributes to OSA, an intermittent obstruction in the passage of air that can lead to hypoxemia and hypercarbia.…”

Why is residual neuromuscular blockade a universal issue?

“…In this issue of CMRO, Yu et al 1 examined the incidence of rNMB in 1571 patients across 32 hospitals in China. Neuromuscular blockade for patients undergoing abdominal surgery (67% laparoscopic) was assessed intraoperatively and in the post anesthesia care unit (PACU) with acceleromyography (AMG) after a normalized baseline was established.…”