4.6 Review

Intraoperative Monitoring of Neuromuscular Blockade

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Article Anesthesiology

Peri-operative management of neuromuscular blockade A guideline from the European Society of Anaesthesiology and Intensive Care

Thomas Fuchs-Buder et al.

Summary: Recent data shows a high incidence of inappropriate management of neuromuscular block and the associated complications. This guideline aims to provide evidence-based recommendations to improve patient care and safety. The recommendations include the use of muscle relaxants for intubation and the monitoring of residual paralysis.

EUROPEAN JOURNAL OF ANAESTHESIOLOGY (2023)

Article Anesthesiology

Effect of quantitative versus qualitative neuromuscular blockade monitoring on rocuronium consumption in patients undergoing abdominal and gynecological surgery: a retrospective cohort study

Lea Valeska Blum et al.

Summary: This study compares the impact of qualitative and quantitative methods of neuromuscular monitoring on the dosage of neuromuscular blocking agents and the need for reversion. The findings suggest that quantitative monitoring systems can reduce drug dosage and the frequency of repeated administration while achieving continuous neuromuscular blockade.

JOURNAL OF CLINICAL MONITORING AND COMPUTING (2023)

Article Anesthesiology

2023 American Society of Anesthesiologists Practice Guidelines for Monitoring and Antagonism of Neuromuscular Blockade: A Report by the American Society of Anesthesiologists Task Force on Neuromuscular Blockade

Stephan R. Thilen et al.

Summary: These practice guidelines provide evidence-based recommendations on managing neuromuscular monitoring and antagonizing neuromuscular blocking agents during and after general anesthesia. The focus is on monitoring type and site, as well as the process of antagonizing neuromuscular blockade to minimize residual neuromuscular blockade.

ANESTHESIOLOGY (2023)

Article Anesthesiology

Quantitative Neuromuscular Monitoring in Clinical Practice: A Professional Practice Change Initiative

Wade A. Weigel et al.

Summary: Quantitative neuromuscular monitoring is effective in reducing residual neuromuscular blockade and improving patient outcomes. Implementing a professional practice initiative, the authors successfully documented train-of-four ratios for the majority of patients, resulting in decreased pulmonary complications and shorter hospital stays.

ANESTHESIOLOGY (2022)

Article Veterinary Sciences

Neuromuscular blockade effects of cisatracurium in 11 cats undergoing ophthalmological surgery anaesthetised with isoflurane

Anne-Sophie Van Wijnsberghe et al.

Summary: The study demonstrated that 0.15 mg/kg IV cisatracurium did not consistently induce complete neuromuscular blockade in all cats, but was sufficient to achieve central eyeball position for ophthalmic surgeries.

JOURNAL OF FELINE MEDICINE AND SURGERY (2022)

Article Anesthesiology

Comparison of neuromuscular block measured by compressomyography at the upper arm and electromyography at the adductor pollicis muscle in obese and non-obese patients: An observational study

G. H. M. Honing et al.

Summary: This study evaluated the agreement between neuromuscular block measured by compressomyography at the upper arm and electromyography at the adductor pollicis muscle in obese and non-obese patients, and found variable disagreement between the two methods. This may have consequences for decisions regarding reversal and extubation in clinical practice.

JOURNAL OF CLINICAL ANESTHESIA (2022)

Review Chemistry, Analytical

Phonomyography on Perioperative Neuromuscular Monitoring: An Overview

Yanjie Dong et al.

Summary: This article summarizes the progression of neuromuscular monitoring based on phonomyography (PMG) in the perioperative period, and discusses the merits, demerits, and challenges of PMG-based equipment.

SENSORS (2022)

Article Anesthesiology

A comparison of accelerometric monitoring by TOF Watch® SX and electromyographic monitoring by Tetragraph® for recovery from neuromuscular blockade

Giorgio Giudici et al.

Summary: The bias between TOF Watch SX and Tetragraph TOF-ratios is consistent with previous results for AMG and EMG monitors. The relative intraobserver variability of EMG was lower compared with AMG.

JOURNAL OF CLINICAL ANESTHESIA (2021)

Article Medicine, General & Internal

Comparison of the Time to Extubation and Length of Stay in the PACU after Sugammadex and Neostigmine Use in Two Types of Surgery: A Monocentric Retrospective Analysis

Cyrus Motamed et al.

Summary: Sugammadex provides rapid pharmacological reversal of aminosteroid and leads to fewer pulmonary complications, better physiological recovery, and shorter postanesthetic recovery unit (PACU) stays. Compared to neostigmine, sugammadex significantly shortens the time to reach a 90% train of four (TOF) recovery, ensuring a higher level of reversal efficiency.

JOURNAL OF CLINICAL MEDICINE (2021)

Review Oncology

Efficacy and safety of neostigmine for neuromuscular blockade reversal in patients under general anesthesia: a systematic review and meta-analysis

Wentao Ji et al.

Summary: Neostigmine has been shown to effectively reduce post-anesthesia care unit stay, time to recovery of train-of-four ratio =0.9, and extubation time in patients recovering from general anesthesia. However, there were no significant differences in adverse events between the neostigmine and control groups. Subgroup analyses based on neostigmine dosage did not affect the overall results. Neostigmine can safely enhance neuromuscular recovery from nondepolarizing muscle relaxants in patients under general anesthesia.

ANNALS OF TRANSLATIONAL MEDICINE (2021)

Article Anesthesiology

Comparison of the TetraGraph and TOFscan for monitoring recovery from neuromuscular blockade in the Post Anesthesia Care Unit

J. Ross Renew et al.

Summary: The study found that TG and TS provide interchangeable quantitative measurements once the TOF ratio has returned to a value of 0.90 or greater in the PACU.

JOURNAL OF CLINICAL ANESTHESIA (2021)

Article Anesthesiology

Identifying high dose neostigmine as a risk factor for post-operative respiratory complications: a case-control study

Shreya Ranjan et al.

Summary: This case-control study identified high dose neostigmine as an independent risk factor for post-operative respiratory complications, while rocuronium dose and the use of train-of-four peripheral nerve stimulator were not associated with these complications.

ANAESTHESIOLOGY INTENSIVE THERAPY (2021)

Article Anesthesiology

Guidelines on muscle relaxants and reversal in anaesthesia

Benoit Plaud et al.

ANAESTHESIA CRITICAL CARE & PAIN MEDICINE (2020)

Letter Anesthesiology

Comparison of the four-train measurement with a new TOF Cuff® device versus TOF Watch® accelerometer

Migena Demiri et al.

ANAESTHESIA CRITICAL CARE & PAIN MEDICINE (2020)

Article Veterinary Sciences

Treatment of Infiltrative Superficial Tumors in Awake Standing Horses Using Novel High-Frequency Pulsed Electrical Fields

Christopher R. Byron et al.

FRONTIERS IN VETERINARY SCIENCE (2019)

Article Pharmacology & Pharmacy

A multicenter survey on the use of neuromuscular blockade in Greece. Does the real-world clinical practice indicate the necessity of guidelines?

Chrysanthi Batistaki et al.

JOURNAL OF ANAESTHESIOLOGY CLINICAL PHARMACOLOGY (2019)

Review Biochemistry & Molecular Biology

The Structure of Human Neuromuscular Junctions: Some Unanswered Molecular Questions

Clarke R. Slater

INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES (2017)

Editorial Material Anesthesiology

Special announcement: Guidelines to the Practice of Anesthesia - Revised Edition 2016

Richard N. Merchant et al.

CANADIAN JOURNAL OF ANESTHESIA-JOURNAL CANADIEN D ANESTHESIE (2016)

Letter Anesthesiology

Calibration of the neuromuscular monitor: Is it necessary?

Casper Claudius

CANADIAN JOURNAL OF ANESTHESIA-JOURNAL CANADIEN D ANESTHESIE (2016)

Article Anesthesiology

Comparison of the TOF-Scan™ acceleromyograph to TOF-Watch SX™: Influence of calibration

Nora Colegrave et al.

ANAESTHESIA CRITICAL CARE & PAIN MEDICINE (2016)

Article Anesthesiology

Comparison of train-of-four count by anesthesia providers versus TOF-WatchA® SX: a prospective cohort study

Sanjay M. Bhananker et al.

CANADIAN JOURNAL OF ANESTHESIA-JOURNAL CANADIEN D ANESTHESIE (2015)

Review Neurosciences

The functional organization of motor nerve terminals

Clarke R. Slater

PROGRESS IN NEUROBIOLOGY (2015)

Editorial Material Anesthesiology

Neuromuscular Monitoring More than Meets the Eye

Francois Donati

ANESTHESIOLOGY (2012)

Editorial Material Anesthesiology

Neuromuscular Monitoring: What Evidence Do We Need to Be Convinced?

Francois Donati

ANESTHESIA AND ANALGESIA (2010)

Article Anesthesiology

Comparison of phonomyography, kinemyography and mechanomyography for neuromuscular monitoring

G Trager et al.

CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE (2006)