Neuromuscular blocking drugs have been used in anesthesia practice since at least 1942 and have become a routine component of many if not most general anesthetics. Despite this, only in recent times have we focused on ensuring, with a high degree of certainty, that patients do not remain partially paralyzed at the conclusion of an anesthetic. Numerous recent studies have documented that some patients are in fact partially paralyzed for a period of time after anesthesia, sometimes to their detriment. We know that subjective twitch monitoring with a peripheral nerve stimulator is not sufficiently sensitive for detection of clinically significant fade in the train-of-four. Sugammadex, a highly effective reversal agent for aminosteroid nondepolarizing neuromuscular blocking drugs, and improved quantitative neuromuscular blockade monitors (so-called twitch monitors) have been mobilized in an effort to prevent residual paralysis.

In...

You do not currently have access to this content.