Should Neuromuscular Blockade Be Routinely Reversed?

Should Neuromuscular Blockade Be Routinely Reversed? 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. . . . Keywords Residual paralysis Neuromuscular blocking agents Neuromuscular monitoring Postoperative respiratory . . . complications Anticholinesterase agents Neostigmine Sugammadex Introduction Does Residual Paralysis Exist? Despite important advances in knowledge relating to dosing, Every physician should understand that neuromuscular monitoring, and reversal of neuromuscular blockade, the rou- blocking agents (NMBAs) do not have the same effect on all tine use of http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Current Anesthesiology Reports Springer Journals

Should Neuromuscular Blockade Be Routinely Reversed?

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Publisher
Springer US
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/s40140-018-0263-8
Publisher site
See Article on Publisher Site

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. . . . Keywords Residual paralysis Neuromuscular blocking agents Neuromuscular monitoring Postoperative respiratory . . . complications Anticholinesterase agents Neostigmine Sugammadex Introduction Does Residual Paralysis Exist? Despite important advances in knowledge relating to dosing, Every physician should understand that neuromuscular monitoring, and reversal of neuromuscular blockade, the rou- blocking agents (NMBAs) do not have the same effect on all tine use of

Journal

Current Anesthesiology ReportsSpringer Journals

Published: Apr 14, 2018

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