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Current Anesthesiology Reports
Published in: Current Anesthesiology Reports 2/2018

01-06-2018 | Neuromuscular Blockade (GS Murphy, Section Editor)

Should Neuromuscular Blockade Be Routinely Reversed?

Authors: Julien Raft, Claude Meistelman

Published in: Current Anesthesiology Reports | Issue 2/2018

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Abstract

Purpose of review

The purpose of this article is to present the consequences and incidence of residual paralysis and define solutions to reduce the risk of its occurrence.

Recent findings

Small degrees of residual paralysis, defined as a train-of-four (TOF) ratio < 0.9, may increase the risk of postoperative respiratory complications and influence outcomes following surgery. Routine monitoring of neuromuscular block can allow the detection of incomplete neuromuscular recovery and is an important factor in the prevention of residual paralysis. Administration of neostigmine or sugammadex to reverse residual paralysis should be based on the degree of spontaneous recovery. Sugammadex acts much faster than neostigmine and can even reverse deep levels of neuromuscular blockade.

Summary

Meticulous management of neuromuscular blockade, including routine reversal of the effects of muscle relaxants, is essential in avoiding residual block and associated complications.
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Metadata
Title
Should Neuromuscular Blockade Be Routinely Reversed?
Authors
Julien Raft
Claude Meistelman
Publication date
01-06-2018
Publisher
Springer US
Published in
Current Anesthesiology Reports / Issue 2/2018
Electronic ISSN: 2167-6275
DOI
https://doi.org/10.1007/s40140-018-0263-8

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