Monitoring of neuromuscular block

The first 150 words of the full text of this article appear below. Key points Postoperative residual curarization occurs evenafter administration of intermediate-acting non-depolarizingneuromuscular blocking drugs, for example, atracurium or vecuronium. Satisfactoryrecovery from neuromuscular block has not occured until thetrain-of-four ratio is >0.9. Quantitative methods of measuringevoked responses, for the example, acceleromyography or mechanomyography,are necessary to ensure adequate recovery from block. Onsetand recovery from neuromuscular block occurs at different ratesin different muscles. Anticholinesterases should not be usedto antagonize residual neuromuscular block unless full recoveryhas been demonstrated.   There is increasing evidence that residual neuromuscular blockis common, and also that it may adversely affect patient outcome.A study by Debaene and colleagues¹ found that 45% of patientshad residual curarization (train-of-four [TOF] ratio<0.9)in the postoperative recovery room after a single intubatingdose of the intermediate-acting drugs atracurium, vecuroniumor rocuronium. Another study found residual curarization (TOFratio<0.7) in 42% of patients in the . . . [Full Text of this Article]