We agree with Raju and Rodney that quantitative monitoring of neuromuscular block should be standard practice, and routinely documented . The Association of Anaesthetists (AAGBI) recommend that quantitative neuromuscular monitoring is used when neuromuscular blocking drugs are administered , but not that adequate reversal is documented in the anaesthetic record, or that this should be included in the minimum anaesthesia record dataset.A recent departmental audit found that only 47 out of 100 patients administered neuromuscular blockers had had any form of neuromuscular monitoring documented, and only 22 out of 100 patients had documented any evidence of adequate reversal before extubation. Thirty‐eight out of 58 patients who had been administered reversal agents had not had the quantitative adequacy of their reversal documented. When recorded, the notation used to indicate adequate reversal varied considerably. Based on these findings, our department recommends addending anaesthesia records to indicate ‘confirmed full reversal of neuromuscular blockade Yes/No’.We suggest that any minimum anaesthesia dataset should include details of adequate reversal of neuromuscular blockade , and urge national bodies to update these accordingly. Similarly, we encourage anaesthetic departments to consider altering their anaesthetic records to include this information.ReferencesRaju P, Rodney G. Moderate vs. deep neuromuscular blockade and monitoring. Anaesthesia 2018; 73: 132–3.Association of Anaesthetists of Great Britain and Ireland. Recommendations for standards of monitoring during anaesthesia and recovery 2015. Anaesthesia 2016; 71: 85–93.Naguib M, Brull SJ, Johnson KB. Conceptual and technical insights into the basis of neuromuscular monitoring. Anaesthesia 2017; 72: 16–37.
Anaesthesia – Wiley
Published: Jan 1, 2018
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