Neuromuscular Blockade Monitoring

Abstract

Neuromuscular monitoring is essential for optimal management of neuromuscular blocking drugs. Postoperative residual neuromuscular blockade continues to occur with an unacceptably high incidence and is associated with adverse patient outcomes. Use of a peripheral nerve stimulator and subjective tactile or visual assessment is useful for intraoperative management of neuromuscular blockade, especially when the patient's hand is accessible. Quantitative monitoring is necessary for confirmation of adequate reversal and for identification of patients who have recovered spontaneously and therefore should not receive pharmacologic reversal agents. Guidelines, as well as more user-friendly monitoring equipment, have created momentum toward improving routine perioperative neuromuscular monitoring.

Keywords: Anesthesia recovery period or anesthesia recovery; Nerve stimulation; Neuromuscular block or neuromuscular blocking or neuromuscular blockade; Neuromuscular monitoring; Postoperative or residual neuromuscular weakness.