Current Status of Neuromuscular Reversal and Monitoring

Anesthesiology

Volumn 126, Issue 1, 2017, Pages 173-190

  Brull, Sorin J ^a   Kopman, Aaron F ^b  

^a MAYO CLINIC   (United States)

^b NONE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ACETYLCHOLINESTERASE; EDROPHONIUM; MUSCLE RELAXANT AGENT; NEOSTIGMINE; CHOLINESTERASE INHIBITOR; NEUROMUSCULAR BLOCKING AGENT;

CLINICAL EVALUATION; FOOD AND DRUG ADMINISTRATION; GRIP STRENGTH; HEAD MOVEMENT; HUMAN; MUSCLE STRENGTH; MUSCLE WEAKNESS; NEUROMUSCULAR BLOCKING; NEUROMUSCULAR FUNCTION; NEUROMUSCULAR MONITORING; PARALYSIS; PATIENT SAFETY; PERIOPERATIVE PERIOD; PERIPHERAL NERVE STIMULATOR; PRIORITY JOURNAL; REVIEW; TACTILE STIMULATION; TIDAL VOLUME; VISUAL STIMULATION; VITAL CAPACITY; ANESTHETIC RECOVERY; ANTAGONISTS AND INHIBITORS; CHEMICALLY INDUCED; DOSE RESPONSE; ELECTROSTIMULATION; PHYSIOLOGIC MONITORING; POSTOPERATIVE COMPLICATIONS; PROCEDURES;

ANESTHESIA RECOVERY PERIOD; CHOLINESTERASE INHIBITORS; DOSE-RESPONSE RELATIONSHIP, DRUG; ELECTRIC STIMULATION; HUMANS; MONITORING, PHYSIOLOGIC; MUSCLE WEAKNESS; NEUROMUSCULAR BLOCKADE; NEUROMUSCULAR NONDEPOLARIZING AGENTS; PARALYSIS; PERIOPERATIVE CARE; POSTOPERATIVE COMPLICATIONS;

EID: 85006058905     PISSN: 00033022     EISSN: 15281175     Source Type: Journal    
DOI: 10.1097/ALN.0000000000001409     Document Type: Review

References (133)

1. Barash P, Bieterman K, Hersey D: Game changers: The 20 most important anesthesia articles ever published. Anesth Analg 2015; 120:663-70
2. Griffith HR, Johnson GE: The use of curare in general anesthesia. Anesthesiology 1942; 3:414-20
3. Beecher HK, Todd DP: A study of the deaths associated with anesthesia and surgery: Based on a study of 599, 548 anesthesias in ten institutions 1948-1952, inclusive. Ann Surg 1954; 140:2-35
4. Gätke MR, Viby-Mogensen J, Rosenstock C, Jensen FS, Skovgaard LT: Postoperative muscle paralysis after rocuronium: Less residual block when acceleromyography is used. Acta Anaesthesiol Scand 2002; 46:207-13
5. Cammu G, De Witte J, De Veylder J, Byttebier G, Vandeput D, Foubert L, Vandenbroucke G, Deloof T: Postoperative residual paralysis in outpatients versus inpatients. Anesth Analg 2006; 102:426-9
6. Kim KS, Cheong MA, Lee HJ, Lee JM: Tactile assessment for the reversibility of rocuronium-induced neuromuscular blockade during propofol or sevoflurane anesthesia. Anesth Analg 2004; 99:1080-5
7. Fortier LP, McKeen D, Turner K, de Médicis É, Warriner B, Jones PM, Chaput A, Pouliot JF, Galarneau A: The RECITE study: A Canadian Prospective, Multicenter Study of the Incidence and Severity of Residual Neuromuscular Blockade. Anesth Analg 2015; 121:366-72
8. Aytac I, Postaci A, Aytac B, Sacan O, Alay GH, Celik B, Kahveci K, Dikmen B: Survey of postoperative residual curarization, acute respiratory events and approach of anesthesiologists. Braz J Anesthesiol 2016; 66:55-62
9. Thomsen JL, Nielsen CV, Palmqvist DF, Gätke MR: Premature awakening and underuse of neuromuscular monitoring in a registry of patients with butyrylcholinesterase deficiency. Br J Anaesth 2015; 115(Suppl 1):i89-94
10. Schuller PJ, Newell S, Strickland PA, Barry JJ: Response of bispectral index to neuromuscular block in awake volunteers. Br J Anaesth 2015; 115(Suppl 1):i95-i103
11. Todd MM, Hindman BJ: The implementation of quantitative electromyographic neuromuscular monitoring in an academic anesthesia department: Follow-up observations. Anesth Analg 2015; 121:836-8
12. Rodney G, Raju PK, Ball DR: Not just monitoring; a strategy for managing neuromuscular blockade. Anaesthesia 2015; 70:1105-9
13. Lumb AB, McLure HA: AAGBI recommendations for standards of monitoring during anaesthesia and recovery 2015-a further example of 'aggregation of marginal gains.' Anaesthesia 2016; 71:3-6
14. Thomsen JL, Nielsen CV, Eskildsen KZ, Demant MN, Gätke MR: Awareness during emergence from anaesthesia: Significance of neuromuscular monitoring in patients with butyrylcholinesterase deficiency. Br J Anaesth 2015; 115(Suppl 1):i78-88
15. Berg H, Roed J, Viby-Mogensen J, Mortensen CR, Engbaek J, Skovgaard LT, Krintel JJ: Residual neuromuscular block is a risk factor for postoperative pulmonary complications. A prospective, randomised, and blinded study of postoperative pulmonary complications after atracurium, vecuronium and pancuronium. Acta Anaesthesiol Scand 1997; 41:1095-103
16. Murphy GS, Szokol JW, Marymont JH, Greenberg SB, Avram MJ, Vender JS: Residual neuromuscular blockade and critical respiratory events in the postanesthesia care unit. Anesth Analg 2008; 107:130-7
17. Murphy GS, Szokol JW, Marymont JH, Greenberg SB, Avram MJ, Vender JS, Nisman M: Intraoperative acceleromyographic monitoring reduces the risk of residual neuromuscular blockade and adverse respiratory events in the postanesthesia care unit. Anesthesiology 2008; 109:389-98
18. Murphy GS, Szokol JW, Avram MJ, Greenberg SB, Marymont JH, Vender JS, Gray J, Landry E, Gupta DK: Intraoperative acceleromyography monitoring reduces symptoms of muscle weakness and improves quality of recovery in the early postoperative period. Anesthesiology 2011; 115:946-54
19. Phillips S, Stewart PA, Bilgin AB: A survey of the management of neuromuscular blockade monitoring in Australia and New Zealand. Anaesth Intensive Care 2013; 41:374-9
20. Kotake Y, Ochiai R, Suzuki T, Ogawa S, Takagi S, Ozaki M, Nakatsuka I, Takeda J: Reversal with sugammadex in the absence of monitoring did not preclude residual neuromuscular block. Anesth Analg 2013; 117:345-51
21. Todd MM, Hindman BJ, King BJ: The implementation of quantitative electromyographic neuromuscular monitoring in an academic anesthesia department. Anesth Analg 2014; 119:323-31
22. Ledowski T, Hillyard S, O'Dea B, Archer R, Vilas-Boas F, Kyle B: Introduction of sugammadex as standard reversal agent: Impact on the incidence of residual neuromuscular blockade and postoperative patient outcome. Indian J Anaesth 2013; 57:46-51
23. Batistaki C, Tentes P, Deligiannidi P, Karakosta A, Florou P, Kostopanagiotou G: Residual neuromuscular blockade in a real life clinical setting: Correlation with sugammadex or neostigmine administration. Minerva Anestesiol 2016; 82:550-8
24. Ledowski T, O'Dea B, Meyerkort L, Hegarty M, von Ungern-Sternberg BS: Postoperative residual neuromuscular paralysis at an Australian Tertiary Children's Hospital. Anesthesiol Res Pract 2015; 2015:410248
25. Playfor S, Jenkins I, Boyles C, Choonara I, Davies G, Haywood T, Hinson G, Mayer A, Morton N, Ralph T, Wolf A; United Kingdom Paediatric Intensive Care Society Sedation, Analgesia and Neuromuscular Blockade Working Group: Consensus guidelines for sustained neuromuscular blockade in critically ill children. Paediatr Anaesth 2007; 17:881-7
26. Greenberg SB, Vender J: The use of neuromuscular blocking agents in the ICU: Where are we now? Crit Care Med 2013; 41:1332-44
27. Salciccioli JD, Cocchi MN, Rittenberger JC, Peberdy MA, Ornato JP, Abella BS, Gaieski DF, Clore J, Gautam S, Giberson T, Callaway CW, Donnino MW: Continuous neuromuscular blockade is associated with decreased mortality in post-cardiac arrest patients. Resuscitation 2013; 84:1728-33
28. Parker MM, Schubert W, Shelhamer JH, Parrillo JE: Perceptions of a critically ill patient experiencing therapeutic paralysis in an ICU. Crit Care Med 1984; 12:69-71
29. Ballard N, Robley L, Barrett D, Fraser D, Mendoza I: Patients' recollections of therapeutic paralysis in the intensive care unit. Am J Crit Care 2006; 15:86-94; quiz 95
30. Polderman KH, Herold I: Therapeutic hypothermia and controlled normothermia in the intensive care unit: Practical considerations, side effects, and cooling methods. Crit Care Med 2009; 37:1101-20
31. Strauss PZ, Lewis MM: Identifying and treating postanesthesia emergencies. OR Nurse 2015; 9:24-30 Available at: http://www.nursingcenter.com/cearticle?an= 01271211-20151100000007&Journal-ID=682710&Issue- ID=3240379. Accessed June 9, 2016
32. Naguib M, Kopman AF, Lien CA, Hunter JM, Lopez A, Brull SJ: A survey of current management of neuromuscular block in the United States and Europe. Anesth Analg 2010; 111:110-9
33. Videira RL, Vieira JE: What rules of thumb do clinicians use to decide whether to antagonize nondepolarizing neuromuscular blocking drugs? Anesth Analg 2011; 113:1192-6
34. National Center for Health Statistics, Centers for Disease Control and Prevention: FastStats-Inpatient Surgery. Available at: http://www.cdc.gov/nchs/fastats/inpatient-surgery. htm. Accessed June 9, 2016
35. Weiser TG, Regenbogen SE, Thompson KD, Haynes AB, Lipsitz SR, Berry WR, Gawande AA: An estimation of the global volume of surgery: A modelling strategy based on available data. Lancet 2008; 372:139-44
36. Czech Society of Anaesthesiology and Intensive Care Medicine: Practice Parameters For The Safe and Effective Use of Neuromuscular Blocking Drugs In Anaesthesia. Available at: http://www.akutne.cz/res/file/doporucene postupy/15- Practice parameters for the safe and effective use of neuromuscular- blocking drugs in anaesth.pdf. 2010. Accessed June 9, 2016
37. Indications of neuromuscular blockade in anaesthesia. Short text. Ann Fr Anesth Reanim 2000; 19(Suppl 2):352s-5s
38. Checketts MR, Alladi R, Ferguson K, Gemmell L, Handy JM, Klein AA, Love NJ, Misra U, Morris C, Nathanson MH, Rodney GE, Verma R, Pandit JJ; Association of Anaesthetists of Great Britain and Ireland: Recommendations for standards of monitoring during anaesthesia and recovery 2015: Association of Anaesthetists of Great Britain and Ireland. Anaesthesia 2016; 71:85-93
39. American Society of Anesthesiologists; Standards and Guidelines. Available at: http://www.asahq.org/qualityand-practice-management/standards-and-guidelines. 2016. Accessed June 9, 2016
40. Apfelbaum JL, Silverstein JH, Chung FF, Connis RT, Fillmore RB, Hunt SE, Nickinovich DG, Schreiner MS, Silverstein JH, Apfelbaum JL, Barlow JC, Chung FF, Connis RT, Fillmore RB, Hunt SE, Joas TA, Nickinovich DG, Schreiner MS; American Society of Anesthesiologists Task Force on Postanesthetic Care: Practice guidelines for postanesthetic care: An updated report by the American Society of Anesthesiologists Task Force on Postanesthetic Care. Anesthesiology 2013; 118:291-307
41. The Official Journal of the Anesthesia Patient Safety Foundation 2016; 30:45-76. Available at: http://issuu.com/ enews/docs/feb2016?e=1607375/33158119. 2016. Accessed June 9, 2016
42. El-Orbany M, Ali HH, Baraka A, Salem MR: Residual neuromuscular block should, and can, be a "never event." Anesth Analg 2014; 118:691
43. Brull SJ, Prielipp RC: Reversal of neuromuscular blockade: "Identification friend or foe." Anesthesiology 2015; 122:1183-5
44. Magorian TT, Lynam DP, Caldwell JE, Miller RD: Can early administration of neostigmine, in single or repeated doses, alter the course of neuromuscular recovery from a vecuronium-induced neuromuscular blockade? Anesthesiology 1990; 73:410-4
45. Payne JP, Hughes R, Al Azawi S: Neuromuscular blockade by neostigmine in anaesthetized man. Br J Anaesth 1980; 52:69-76
46. McLean DJ, Diaz-Gil D, Farhan HN, Ladha KS, Kurth T, Eikermann M: Dose-dependent association between intermediate-acting neuromuscular-blocking agents and postoperative respiratory complications. Anesthesiology 2015; 122:1201-13
47. Eikermann M, Fassbender P, Malhotra A, Takahashi M, Kubo S, Jordan AS, Gautam S, White DP, Chamberlin NL: Unwarranted administration of acetylcholinesterase inhibitors can impair genioglossus and diaphragm muscle function. Anesthesiology 2007; 107:621-9
48. Grosse-Sundrup M, Henneman JP, Sandberg WS, Bateman BT, Uribe JV, Nguyen NT, Ehrenfeld JM, Martinez EA, Kurth T, Eikermann M: Intermediate acting non-depolarizing neuromuscular blocking agents and risk of postoperative respiratory complications: Prospective propensity score matched cohort study. BMJ 2012; 345:e6329
49. Sasaki N, Meyer MJ, Malviya SA, Stanislaus AB, MacDonald T, Doran ME, Igumenshcheva A, Hoang AH, Eikermann M: Effects of neostigmine reversal of nondepolarizing neuromuscular blocking agents on postoperative respiratory outcomes: A prospective study. Anesthesiology 2014; 121:959-68
50. Fuchs-Buder T, Claudius C, Skovgaard LT, Eriksson LI, Mirakhur RK, Viby-Mogensen J; 8th International Neuromuscular Meeting: Good clinical research practice in pharmacodynamic studies of neuromuscular blocking agents II: The Stockholm revision. Acta Anaesthesiol Scand 2007; 51:789-808
51. Lemmens HJ, El-Orbany MI, Berry J, Morte JB Jr, Martin G: Reversal of profound vecuronium-induced neuromuscular block under sevoflurane anesthesia: Sugammadex versus neostigmine. BMC Anesthesiol 2010; 10:15
52. Jones RK, Caldwell JE, Brull SJ, Soto RG: Reversal of profound rocuronium-induced blockade with sugammadex: A randomized comparison with neostigmine. Anesthesiology 2008; 109:816-24
53. Caldwell JE, Robertson EN, Baird WL: Antagonism of profound neuromuscular blockade induced by vecuronium or atracurium. Comparison of neostigmine with edrophonium. Br J Anaesth 1986; 58:1285-9
54. Keens SJ, Hunter JM, Snowdon SL, Utting JE: Potentiation of the neuromuscular blockade produced by alcuronium with halothane, enflurane and isoflurane. Br J Anaesth 1987; 59:1011-6
55. Naguib M, Seraj M, Abdulrazik E: Pipecuronium-induced neuromuscular blockade during nitrous oxide-fentanyl, enflurane, isoflurane, and halothane anesthesia in surgical patients. Anesth Analg 1992; 75:193-7
56. Bock M, Klippel K, Nitsche B, Bach A, Martin E, Motsch J: Rocuronium potency and recovery characteristics during steady-state desflurane, sevoflurane, isoflurane or propofol anaesthesia. Br J Anaesth 2000; 84:43-7
57. Cronnelly R, Morris RB, Miller RD: Edrophonium: Duration of action and atropine requirement in humans during halothane anesthesia. Anesthesiology 1982; 57:261-6
58. Beemer GH, Bjorksten AR, Dawson PJ, Dawson RJ, Heenan PJ, Robertson BA: Determinants of the reversal time of competitive neuromuscular block by anticholinesterases. Br J Anaesth 1991; 66:469-75
59. Kopman AF, Kopman DJ, Ng J, Zank LM: Antagonism of profound cisatracurium and rocuronium block: The role of objective assessment of neuromuscular function. J Clin Anesth 2005; 17:30-5
60. Viby-Mogensen J, Jensen NH, Engbaek J, Ording H, Skovgaard LT, Chraemmer-Jørgensen B: Tactile and visual evaluation of the response to train-of-four nerve stimulation. Anesthesiology 1985; 63:440-3
61. Kirkegaard H, Heier T, Caldwell JE: Efficacy of tactile-guided reversal from cisatracurium-induced neuromuscular block. Anesthesiology 2002; 96:45-50
62. Harper NJ, Wallace M, Hall IA: Optimum dose of neostigmine at two levels of atracurium-induced neuromuscular block. Br J Anaesth 1994; 72:82-5
63. Fuchs-Buder T, Meistelman C, Alla F, Grandjean A, Wuthrich Y, Donati F: Antagonism of low degrees of atracuriuminduced neuromuscular blockade: Dose-effect relationship for neostigmine. Anesthesiology 2010; 112:34-40
64. Claudius C, Skovgaard LT, Viby-Mogensen J: Is the performance of acceleromyography improved with preload and normalization? A comparison with mechanomyography. Anesthesiology 2009; 110:1261-70
65. Schaller SJ, Fink H, Ulm K, Blobner M: Sugammadex and neostigmine dose-finding study for reversal of shallow residual neuromuscular block. Anesthesiology 2010; 113:1054-60
66. Fuchs-Buder T, Baumann C, De Guis J, Guerci P, Meistelman C: Low-dose neostigmine to antagonise shallow atracurium neuromuscular block during inhalational anaesthesia: A randomised controlled trial. Eur J Anaesthesiol 2013; 30:594-8
67. Kaufhold N, Schaller SJ, Stäuble CG, Baumüller E, Ulm K, Blobner M, Fink H: Sugammadex and neostigmine dose-finding study for reversal of residual neuromuscular block at a train-offour ratio of 0.2 (SUNDRO20). Br J Anaesth 2016; 116:233-40
68. Goldhill DR, Wainwright AP, Stuart CS, Flynn PJ: Neostigmine after spontaneous recovery from neuromuscular blockade. Effect on depth of blockade monitored with train-of-four and tetanic stimuli. Anaesthesia 1989; 44:293-9
69. Eikermann M, Zaremba S, Malhotra A, Jordan AS, Rosow C, Chamberlin NL: Neostigmine but not sugammadex impairs upper airway dilator muscle activity and breathing. Br J Anaesth 2008; 101:344-9
70. Herbstreit F, Zigrahn D, Ochterbeck C, Peters J, Eikermann M: Neostigmine/glycopyrrolate administered after recovery from neuromuscular block increases upper airway collapsibility by decreasing genioglossus muscle activity in response to negative pharyngeal pressure. Anesthesiology 2010; 113:1280-8
71. Baillard C, Gehan G, Reboul-Marty J, Larmignat P, Samama CM, Cupa M: Residual curarization in the recovery room after vecuronium. Br J Anaesth 2000; 84:394-5
72. Maybauer DM, Geldner G, Blobner M, Pühringer F, Hofmockel R, Rex C, Wulf HF, Eberhart L, Arndt C, Eikermann M: Incidence and duration of residual paralysis at the end of surgery after multiple administrations of cisatracurium and rocuronium. Anaesthesia 2007; 62:12-7
73. Pietraszewski P, Gaszyński T: Residual neuromuscular block in elderly patients after surgical procedures under general anaesthesia with rocuronium. Anaesthesiol Intensive Ther 2013; 45:77-81
74. De Oliveira GS Jr, Theilken LS, McCarthy RJ: Shortage of perioperative drugs: Implications for anesthesia practice and patient safety. Anesth Analg 2011; 113:1429-35
75. U.S. Food &Drug Administration; Notice to Industry: FDA Issues Revised Guidance on Marketed Unapproved Drugs. Available at: http://www.fda.gov/Drugs/GuidanceCompliance RegulatoryInformation/EnforcementActivitiesbyFDA/Selected EnforcementActionsonUnapprovedDrugs/ucm270834.htm. 2011. Accessed June 9, 2016
76. Langreth R, Koons C: 2,000% Drug Price Surge Is a Side Effect of FDA Safety Program. Available at: http://www. bloomberg.com/news/articles/2015-10-06/2-000-drug-pricesurge-is-A-side-effect-of-fda-safety-program. 2015. Accessed June 9, 2016
77. Kopman AF, Mallhi MU, Justo MD, Rodricks P, Neuman GG: Antagonism of mivacurium-induced neuromuscular blockade in humans. Edrophonium dose requirements at threshold train-of-four count of 4. Anesthesiology 1994; 81:1394-400
78. Johnson RA, Harper NJ: Antagonism of moderate degrees of vecuronium-induced neuromuscular block by small doses of neostigmine. Br J Anaesth 1989; 62:483-7
79. Goldhill DR, Embree PB, Ali HH, Savarese JJ: Reversal of pancuronium. Neuromuscular and cardiovascular effects of a mixture of neostigmine and glycopyrronium. Anaesthesia 1988; 43:443-6
80. de Boer HD, van Egmond J, van de Pol F, Bom A, Booij LH: Reversal of profound rocuronium neuromuscular blockade by sugammadex in anesthetized rhesus monkeys. Anesthesiology 2006; 104:718-23
81. de Boer HD, van Egmond J, van de Pol F, Bom A, Booij LH: Sugammadex, a new reversal agent for neuromuscular block induced by rocuronium in the anaesthetized Rhesus monkey. Br J Anaesth 2006; 96:473-9
82. Sorgenfrei IF, Norrild K, Larsen PB, Stensballe J, Ostergaard D, Prins ME, Viby-Mogensen J: Reversal of rocuroniuminduced neuromuscular block by the selective relaxant binding agent sugammadex: A dose-finding and safety study. Anesthesiology 2006; 104:667-74
83. Shields M, Giovannelli M, Mirakhur RK, Moppett I, Adams J, Hermens Y: Org 25969 (sugammadex), a selective relaxant binding agent for antagonism of prolonged rocuronium-induced neuromuscular block. Br J Anaesth 2006; 96:36-43
84. Kopman AF: Sugammadex: A revolutionary approach to neuromuscular antagonism. Anesthesiology 2006; 104:631-3
85. Bom A, Hope F, Rutherford S, Thomson K: Preclinical pharmacology of sugammadex. J Crit Care 2009; 24:29-35
86. Caldwell JE, Miller RD: Clinical implications of sugammadex. Anaesthesia 2009; 64 Suppl 1:66-72
87. Naguib M, Brull SJ: Sugammadex: A novel selective relaxant binding agent. Expert Rev Clin Pharmacol 2009; 2:37-53
88. Srivastava A, Hunter JM: Reversal of neuromuscular block. Br J Anaesth 2009; 103:115-29
89. Partownavid P, Romito BT, Ching W, Berry AA, Barkulis CT, Nguyen KP, Jahr JS: Sugammadex: A comprehensive review of the published human science, including renal studies. Am J Ther 2015; 22:298-317
90. Jahr JS, Miller JE, Hiruma J, Emaus K, You M, Meistelman C: Sugammadex: A scientific review including safety and efficacy, update on regulatory issues, and clinical use in Europe. Am J Ther 2015; 22:288-97
91. Schaller SJ, Fink H: Sugammadex as a reversal agent for neuromuscular block: An evidence-based review. Core Evid 2013; 8:57-67
92. Zwiers A, van den Heuvel M, Smeets J, Rutherford S: Assessment of the potential for displacement interactions with sugammadex: A pharmacokinetic-pharmacodynamic modelling approach. Clin Drug Investig 2011; 31:101-11
93. Galvão VR, Giavina-Bianchi P, Castells M: Perioperative anaphylaxis. Curr Allergy Asthma Rep 2014; 14:452
94. Tsur A, Kalansky A: Hypersensitivity associated with sugammadex administration: A systematic review. Anaesthesia 2014; 69:1251-7
95. Jeyadoss J, Kuruppu P, Nanjappa N, Van Wijk R: Sugammadex hypersensitivity-A case of anaphylaxis. Anaesth Intensive Care 2014; 42:89-92
96. Rahe-Meyer N, Fennema H, Schulman S, Klimscha W, Przemeck M, Blobner M, Wulf H, Speek M, McCrary Sisk C, Williams-Herman D, Woo T, Szegedi A: Effect of reversal of neuromuscular blockade with sugammadex versus usual care on bleeding risk in a randomized study of surgical patients. Anesthesiology 2014; 121:969-77
97. Dirkmann D, Britten MW, Pauling H, Weidle J, Volbracht L, Görlinger K, Peters J: Anticoagulant effect of Sugammadex: Just an in vitro artifact. Anesthesiology 2016; 124:1277-85
98. Della Rocca G, Pompei L, Pagan DE Paganis C, Tesoro S, Mendola C, Boninsegni P, Tempia A, Manstretta S, Zamidei L, Gratarola A, Murabito P, Fuggiano L, DI Marco P: Reversal of rocuronium induced neuromuscular block with sugammadex or neostigmine: A large observational study. Acta Anaesthesiol Scand 2013; 57:1138-45
99. Brueckmann B, Sasaki N, Grobara P, Li MK, Woo T, de Bie J, Maktabi M, Lee J, Kwo J, Pino R, Sabouri AS, McGovern F, Staehr-Rye AK, Eikermann M: Effects of sugammadex on incidence of postoperative residual neuromuscular blockade: A randomized, controlled study. Br J Anaesth 2015; 115:743-51
100. Martinez-Ubieto J, Ortega-Lucea S, Pascual-Bellosta A, Arazo-Iglesias I, Gil-Bona J, Jimenez-Bernardó T, Muñoz-Rodriguez L: Prospective study of residual neuromuscular block and postoperative respiratory complications in patients reversed with neostigmine versus sugammadex. Minerva Anestesiol 2016; 82:735-42
101. Le Corre F, Nejmeddine S, Fatahine C, Tayar C, Marty J, Plaud B: Recurarization after sugammadex reversal in an obese patient. Can J Anaesth 2011; 58:944-7
102. Lien CA, Kopman AF: Current recommendations for monitoring depth of neuromuscular blockade. Curr Opin Anaesthesiol 2014; 27:616-22
103. Bevan DR, Smith CE, Donati F: Postoperative neuromuscular blockade: A comparison between atracurium, vecuronium, and pancuronium. Anesthesiology 1988; 69:272-6
104. Brull SJ, Ehrenwerth J, Connelly NR, Silverman DG: Assessment of residual curarization using low-current stimulation. Can J Anaesth 1991; 38:164-8
105. Murphy GS, Brull SJ: Residual neuromuscular block: Lessons unlearned. Part I: Definitions, incidence, and adverse physiologic effects of residual neuromuscular block. Anesth Analg 2010; 111:120-8
106. Pandit JJ, Andrade J, Bogod DG, Hitchman JM, Jonker WR, Lucas N, Mackay JH, Nimmo AF, O'Connor K, O'Sullivan EP, Paul RG, Palmer JH, Plaat F, Radcliffe JJ, Sury MR, Torevell HE, Wang M, Hainsworth J, Cook TM; Royal College of Anaesthetists; Association of Anaesthetists of Great Britain and Ireland: 5th National Audit Project (NAP5) on accidental awareness during general anaesthesia: Summary of main findings and risk factors. Br J Anaesth 2014; 113:549-59
107. Shorten GD, Merk H, Sieber T: Perioperative train-of-four monitoring and residual curarization. Can J Anaesth 1995; 42:711-5
108. Beemer GH, Rozental P: Postoperative neuromuscular function. Anaesth Intensive Care 1986; 14:41-5
109. Pedersen T, Viby-Mogensen J, Bang U, Olsen NV, Jensen E, Engboek J: Does perioperative tactile evaluation of the train-offour response influence the frequency of postoperative residual neuromuscular blockade? Anesthesiology 1990; 73:835-9
110. Eikermann M, Groeben H, Hüsing J, Peters J: Accelerometry of adductor pollicis muscle predicts recovery of respiratory function from neuromuscular blockade. Anesthesiology 2003; 98:1333-7
111. Brull SJ, Silverman DG: Visual and tactile assessment of neuromuscular fade. Anesth Analg 1993; 77:352-5
112. Naguib M, Kopman AF, Ensor JE: Neuromuscular monitoring and postoperative residual curarisation: A meta-analysis. Br J Anaesth 2007; 98:302-16
113. Drenck NE, Ueda N, Olsen NV, Engbaek J, Jensen E, Skovgaard LT, Viby-Mogensen J: Manual evaluation of residual curarization using double burst stimulation: A comparison with train-of-four. Anesthesiology 1989; 70:578-81
114. Capron F, Fortier LP, Racine S, Donati F: Tactile fade detection with hand or wrist stimulation using train-of-four, double-burst stimulation, 50-hertz tetanus, 100-hertz tetanus, and acceleromyography. Anesth Analg 2006; 102:1578-84
115. Thilen SR, Hansen BE, Ramaiah R, Kent CD, Treggiari MM, Bhananker SM: Intraoperative neuromuscular monitoring site and residual paralysis. Anesthesiology 2012; 117:964-72
116. Donati F: Neuromuscular monitoring: More than meets the eye. Anesthesiology 2012; 117:934-6
117. Bhananker SM, Treggiari MM, Sellers BA, Cain KC, Ramaiah R, Thilen SR: Comparison of train-of-four count by anesthesia providers versus TOF-Watch® SX: A prospective cohort study. Can J Anaesth 2015; 62:1089-96
118. Eriksson LI, Sundman E, Olsson R, Nilsson L, Witt H, Ekberg O, Kuylenstierna R: Functional assessment of the pharynx at rest and during swallowing in partially paralyzed humans: Simultaneous videomanometry and mechanomyography of awake human volunteers. Anesthesiology 1997; 87:1035-43
119. Sundman E, Witt H, Olsson R, Ekberg O, Kuylenstierna R, Eriksson LI: The incidence and mechanisms of pharyngeal and upper esophageal dysfunction in partially paralyzed humans: Pharyngeal videoradiography and simultaneous manometry after atracurium. Anesthesiology 2000; 92:977-84
120. Murphy GS, Szokol JW, Franklin M, Marymont JH, Avram MJ, Vender JS: Postanesthesia care unit recovery times and neuromuscular blocking drugs: A prospective study of orthopedic surgical patients randomized to receive pancuronium or rocuronium. Anesth Analg 2004; 98:193-200
121. Grayling M, Sweeney BP: Recovery from neuromuscular blockade: A survey of practice. Anaesthesia 2007; 62:806-9
122. Kopman AF, Kumar S, Klewicka MM, Neuman GG: The staircase phenomenon: Implications for monitoring of neuromuscular transmission. Anesthesiology 2001; 95:403-7
123. U.S. Food &Drug Administration; Class 2 Device Recall NeuroMuscular Transmission Module, ENMT. Available at: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfres/ res.cfm?id=125850. 2014. Accessed August 7, 2016
124. Chowdhury RH, Reaz MB, Ali MA, Bakar AA, Chellappan K, Chang TG: Surface electromyography signal processing and classification techniques. Sensors (Basel) 2013; 13:12431-66
125. Claudius C, Viby-Mogensen J: Acceleromyography for use in scientific and clinical practice: A systematic review of the evidence. Anesthesiology 2008; 108:1117-40
126. Baillard C, Bourdiau S, Le Toumelin P, Ait Kaci F, Riou B, Cupa M, Samama CM: Assessing residual neuromuscular blockade using acceleromyography can be deceptive in postoperative awake patients. Anesth Analg 2004; 98:854-7
127. Mortensen CR, Berg H, el-Mahdy A, Viby-Mogensen J: Perioperative monitoring of neuromuscular transmission using acceleromyography prevents residual neuromuscular block following pancuronium. Acta Anaesthesiol Scand 1995; 39:797-801
128. Ansermino JM, Sanderson PM, Bevan JC, Bevan DR: Acceleromyography improves detection of residual neuromuscular blockade in children. Can J Anaesth 1996; 43:589-94
129. Motamed C, Kirov K, Combes X, Duvaldestin P: Comparison between the Datex-Ohmeda M-NMT module and a forcedisplacement transducer for monitoring neuromuscular blockade. Eur J Anaesthesiol 2003; 20:467-9
130. Stewart PA, Freelander N, Liang S, Heller G, Phillips S: Comparison of electromyography and kinemyography during recovery from non-depolarising neuromuscular blockade. Anaesth Intensive Care 2014; 42:378-84
131. Xará D, Santos A, Abelha F: Adverse respiratory events in a post-anesthesia care unit. Arch Bronconeumol 2015; 51:69-75
132. Foldes FF: The impact of neuromuscular blocking agents on the development of anaesthesia and surgery, Muscle Relaxants: Monographs in Anaesthesiology, Volume 19. Edited by Agoston S, Bowman WC. New York, Elsevier, 1990, pp 1-17
133. Brull SJ, Murphy GS: Residual neuromuscular block: Lessons unlearned. Part II: methods to reduce the risk of residual weakness. Anesth Analg 2010; 111:129-40