In recent years there has been a significant investment in education on the management of neuromuscular blockade and increased availability of sugammadex in anaesthetic practice. This survey aimed to examine contemporary practice of Australian and New Zealand anaesthetists in managing neuromuscular blockade and its reversal. A web-based, voluntary survey was distributed to a cohort of 1000 Fellows of the Australian and New Zealand College of Anaesthetists. We received 229 completed responses (survey response rate of 23%). Seventy-one percent (95% confidence interval (CI) 64% to 76%) of the survey respondents thought that 5% or fewer of the patients in their hospital display clinically significant postoperative paralysis. Only 35% (95% CI 18% to 29%) thought that quantitative neuromuscular twitch monitors should be used to monitor neuromuscular block, and the dose and time given for reversal agents was often inconsistent with published recommendations. Sugammadex was the preferred reversal agent for 78% (95% CI 72% to 83%) of survey respondents, but they indicated that cost remains a significant barrier to its widespread uptake. Despite the low response rate, this survey identified that some reported practices in Australia and New Zealand deviate from guidelines and current recommendations in the management of neuromuscular blockade. If the respondents are representative of the broader anaesthetic community, there appears be a greater preference for sugammadex over neostigmine for reversal of neuromuscular blockade.
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http://dx.doi.org/10.1177/0310057X21995498 | DOI Listing |
Med Sci Monit
January 2025
Department of Rheumatology, University Clinical Hospital No. 1 Szczecin, Szczecin, Poland.
Skeletal muscle relaxants have their place in everyday use in numerous anesthesiological procedures, such as preparing a patient for surgery, supporting mechanical ventilation, and performing effective intubation. These drugs can be divided, based on their mechanism of action, into depolarizing skeletal relaxants, such as succinylcholine, and non-depolarizing skeletal muscle relaxants. Non-depolarizing agents are further categorized, based on their structure, into steroidal (eg, rocuronium) and benzylisoquinoline (eg, atracurium) compounds.
View Article and Find Full Text PDFBMC Anesthesiol
January 2025
Department of Anesthesiology, The Fourth Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215124, China.
Background: Intravenous anesthesia with high-flow nasal cannula (HFNC) has been reported to benefit oxygen reserves and enhance postoperative recovery in surgeries requiring low neuromuscular blockade. This study investigated whether HFNC improves recovery quality in elderly undergoing ureteroscopic holmium laser lithotripsy (UHLL).
Methods: We enrolled 106 elderly patients undergoing UHLL, with 96 patients (48 per group) included in the final analysis.
Med Sci Monit
January 2025
Department of Nephrology, Transplantology and Internal Diseases, Collegium Medicum University of Warmia and Mazury, Olsztyn, Poland.
Orv Hetil
December 2024
1 Debreceni Egyetem, Általános Orvostudományi Kar, Aneszteziológiai és Intenzív Terápiás Tanszék/Klinika Debrecen, Nagyerdei krt. 98., 4032 Magyarország.
Background: With the clinical integration of sugammadex, a selective relaxant-binding agent, the approach to reversing neuromuscular blockade is revolutionized. Despite its efficacy, sugammadex's adverse reactions range from mild symptoms to severe cases, including anaphylaxis and coagulopathy. Assessing the nature of these reactions using the Food and Drug Administration's Adverse Event Reporting System (FAERS) database is vital for safe anesthetic practice.
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