Key result
Sugammadex was the preferred reversal agent for 78% (95% CI 72-83%) of surveyed anaesthetists, despite cost remaining a significant barrier to widespread uptake.
Why the study?
Following significant investment in neuromuscular blockade education and increased sugammadex availability, this survey aimed to examine contemporary management of neuromuscular blockade and reversal among Australian and New Zealand anaesthetists.
Cross-Sectional (n=229)
Yes
A survey of Australian and New Zealand anaesthetists reveals a strong preference for sugammadex over neostigmine for neuromuscular blockade reversal, though practices often deviate from current guidelines regarding quantitative monitoring and dosing.
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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Olesnicky et al. (2021) conducted a cross-sectional in Neuromuscular blockade management (n=229). Survey on neuromuscular blockade management was evaluated on Preference for sugammadex as reversal agent (95% CI 72-83). Sugammadex was the preferred reversal agent for 78% (95% CI 72-83%) of surveyed anaesthetists, despite cost remaining a significant barrier to widespread uptake.
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