Qualitative Neuromuscular Monitoring: Patterns of Stimulation, Site of Monitoring, and Accuracy in Detecting Residual Neuromuscular Blockade

Qualitative Neuromuscular Monitoring: Patterns of Stimulation, Site of Monitoring, and Accuracy... Purpose of Review Muscle paralysis is a component of many general anesthetics, and monitoring of neuromuscular function is integral to ensuring complete and safe recovery. Recent Findings Recommendations for qualitative neuromuscular blockade have been well-described in the literature for de- cades; however practitioners frequently do not follow recommendations, resulting in patient harm from inadequate reversal of paralysis. Summary This review will focus on evidence-based techniques for patterns of stimulation, sites of monitoring, and accuracy in detecting residual neuromuscular blockade; furthermore, the review will also discuss barriers to implementation of best practices. . . . . . . Keywords Paralysis Neuromuscular blockade Acetylcholinesterase inhibitor Neostigmine Edrophonium Glycopyrrolate . . . Atropine Residual paralysis Postoperative residual curarization Sugammadex Introduction Patterns of Stimulation The classic components of a general anesthetic include Qualitative or subjective monitoring of neuromuscular func- hypnosis, analgesia, and immobility. For nearly a century, tion requires stimulation of a motor nerve, with observation of immobility was achieved via the relaxant properties of the innervated muscle. Patterns of stimulation beyond a single inhaled agents. The agents, however, frequently resulted stimulus (or twitch) reveal more detailed information about in hemodynamic depression. Following the introduction the degree of paralysis, and other modes of http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Current Anesthesiology Reports Springer Journals

Qualitative Neuromuscular Monitoring: Patterns of Stimulation, Site of Monitoring, and Accuracy in Detecting Residual Neuromuscular Blockade

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Publisher
Springer Journals
Copyright
Copyright © 2018 by Springer Science+Business Media, LLC, part of Springer Nature
Subject
Medicine & Public Health; Anesthesiology; Intensive / Critical Care Medicine; Internal Medicine
eISSN
2167-6275
D.O.I.
10.1007/s40140-018-0268-3
Publisher site
See Article on Publisher Site

Abstract

Purpose of Review Muscle paralysis is a component of many general anesthetics, and monitoring of neuromuscular function is integral to ensuring complete and safe recovery. Recent Findings Recommendations for qualitative neuromuscular blockade have been well-described in the literature for de- cades; however practitioners frequently do not follow recommendations, resulting in patient harm from inadequate reversal of paralysis. Summary This review will focus on evidence-based techniques for patterns of stimulation, sites of monitoring, and accuracy in detecting residual neuromuscular blockade; furthermore, the review will also discuss barriers to implementation of best practices. . . . . . . Keywords Paralysis Neuromuscular blockade Acetylcholinesterase inhibitor Neostigmine Edrophonium Glycopyrrolate . . . Atropine Residual paralysis Postoperative residual curarization Sugammadex Introduction Patterns of Stimulation The classic components of a general anesthetic include Qualitative or subjective monitoring of neuromuscular func- hypnosis, analgesia, and immobility. For nearly a century, tion requires stimulation of a motor nerve, with observation of immobility was achieved via the relaxant properties of the innervated muscle. Patterns of stimulation beyond a single inhaled agents. The agents, however, frequently resulted stimulus (or twitch) reveal more detailed information about in hemodynamic depression. Following the introduction the degree of paralysis, and other modes of

Journal

Current Anesthesiology ReportsSpringer Journals

Published: Apr 16, 2018

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