Key result
Residual neuromuscular block is a preventable anesthetic complication through simple measures like timing of reversal, appropriate patient assessment, and surgery-specific usage of NMBAs.
Why the study?
Neuromuscular blockade often continues in the PACU despite acetylcholinesterase inhibitor administration, necessitating risk stratification and evidence-based preventive guidelines in resource-limited settings.
Do preventive strategies reduce the incidence of residual neuromuscular block in patients receiving NMBAs in resource-limited settings?
Systematic Review
Do preventive strategies reduce the incidence of residual neuromuscular block in patients receiving NMBAs in resource-limited settings?
Residual neuromuscular block remains a common and preventable complication that requires risk stratification and simple preventive measures like appropriate timing of reversal.
Adoption of simple preventive measures can eliminate residual block risk; reinforces Level 1 guidelines for NMBA management in surgery.
Background: Following surgery, neuromuscular paralysis is no longer needed, its action could be quickly and effectively terminated. However, evidences shown that NMBAs often continues in the PACU, even after the administration of acetylcholinesterase inhibitor. Hence, stratifying risks of patients and developing evidence-based guidelines are required by rationalizing residual neuromuscular block preventive strategies in resource limiting setup. Methods: Preferred reporting items for systematic reviews and meta-analyses protocol was used to conduct this review. PubMed, Google Scholar, and Cochrane Library data bases were used to find evidences that helps to draw recommendations and conclusions. Discussion: The incidence of residual neuromuscular block is high in aged, female, and hypothermic patients. Full recovery of neuromuscular block may require 15–30 min after administration of anticholinesterase. Conclusions: Undetected neuromuscular block following the administration of NMBAs is still a common problem in today's anesthesia care. A residual neuromuscular block is a preventable anesthetic complication by application of simple measures like the timing of reversal, appropriate assessment of patient and surgery specific usage of NMBAs. Highlights:
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Firde et al. (2020) conducted a systematic review in Residual neuromuscular blockade. Preventive strategies (timing of reversal, appropriate assessment, surgery specific usage of NMBAs) was evaluated on Incidence of residual neuromuscular block. Residual neuromuscular block is a preventable anesthetic complication through simple measures like timing of reversal, appropriate patient assessment, and surgery-specific usage of NMBAs.
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