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Both the American Society of Anesthesiologists (ASA) and European Society of Anaesthesiology and Intensive Care (ESAIC) have published new guidelines on the management of neuromuscular blockade during anesthesia.1,2 In addition to other recommendations, both guidelines strongly recommend using quantitative neuromuscular monitoring (e.g., electromyography or accelerometry) rather than qualitative assessment and confirming a train-of-four ratio ≥0.9 before extubation. They also recommend using sugammadex for reversal rather than neostigmine for patients who have received rocuronium or vecuronium and who have residual block at...
