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Dosing, Monitoring, and Reversal of Neuromuscular Blockade: Are Anesthesiologists Following Evidence-Based Practices?


Paralysis is an integral component of many balanced anesthetics, and appropriate dosing, monitoring, and reversal of paralytic agents are important aspects of anesthetic care. Recommendations for all three have been well-described in the literature, yet the literature is also replete with evidence that providers often do not follow published guidelines, and that patients suffer with residual paralysis with subsequent serious or catastrophic sequelae. We discuss appropriate evidence-based techniques for dosing, monitoring, and reversal of paralytic agents, and barriers to implementation of best practices.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Correspondence to Roy Soto.

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This article is part of the Topical Collection on Neuromuscular Blockade.

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Asbahi, M., Soto, R. Dosing, Monitoring, and Reversal of Neuromuscular Blockade: Are Anesthesiologists Following Evidence-Based Practices?. Curr Anesthesiol Rep 6, 160–163 (2016).

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  • Residual paralysis
  • Neuromuscular blockade
  • Acetylcholinesterase inhibitor