Abstract
Purpose of Review
The purpose of this review is to summarize the importance of monitoring neuromuscular blockade and techniques for the evaluation and documentation of the depth of neuromuscular blockade. It also discusses the most recent societal guidelines for monitoring neuromuscular blockade.
Recent Findings
In 2023, the American Society of Anesthesiologists task force presented practice guidelines that recommended quantitative monitoring at the adductor policies and a recovery of train-of-four ratio to 0.9 prior to extubation. Patients monitored utilizing quantitative monitoring had a lower incidence of residual neuromuscular blockade compared with patients assessed with qualitative monitoring. Despite multiple societies recently recommending quantitative monitoring of depth of neuromuscular blockade, anesthesiology provider use and documentation of this monitoring are imperfect. Studies evaluating the improvement of monitoring and documentation show that providing individual providers with feedback about their performance may improve their performance.
Summary
Continued improvement is needed for both the use of train-of-four monitoring and the documentation of that monitoring. Further studies to evaluate best practices and how to improve compliance are needed.
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Guillow, R., Nemergut, E.C. & Hollis, N. Individualized Data Feedback and Documentation of Depth of Neuromuscular Blockade. Curr Anesthesiol Rep 13, 257–261 (2023). https://doi.org/10.1007/s40140-023-00585-x
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DOI: https://doi.org/10.1007/s40140-023-00585-x