Quantitative Neuromuscular Monitoring: Current Devices, New Technological Advances, and Use in Clinical Practice
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Purpose of Review
The purpose of this review is to summarize various quantitative neuromuscular monitoring modalities and describe strategies to implement them into routine practice. We will contrast these objective modalities with unreliable clinical tests and subjective techniques that expose patients to unnecessary risk associated with postoperative residual weakness.
As major specialty societies publish guidelines and consensus statements urging anesthesiologists to utilize quantitative monitors, clinicians must familiarize themselves with this equipment. Furthermore, new monitors are emerging as the industry tries to address the need for user-friendly, reliable monitors.
Clinical assessment is an unacceptable technique to guide neuromuscular blockade management in patients receiving neuromuscular blocking agents. The use of a peripheral nerve stimulator can provide some information regarding the level of neuromuscular blockade in patients; however, it cannot reliably confirm adequate recovery. The use of objective, quantitative monitoring is an essential practice that helps guide the administration of neuromuscular blocking agents and excludes deleterious postoperative residual weakness.
KeywordsQuantitative monitoring Residual muscle weakness Neuromuscular blockade Patient safety
Compliance with Ethical Standards
Conflict of Interest
Hajime Iwasaki declares that he has no conflict of interest.
Reka Nemes is supported by a visiting student researcher grant from the J. William Fulbright Scholarship Board.
Sorin J. Brull has received research support through a grant from Merck (with funds to Mayo Clinic); has received compensation from Senzime AB for service on the Board of Directors; has served on scientific advisory boards for The Doctors Company, ClearLine MD, and NMD Pharma; and has a patent pending for neuromuscular display licensed to Mayo Clinic.
J. Ross Renew has received research support through a grant from Merck (with funds to Mayo Clinic).
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors..
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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