Key result
The authors advocate for the routine use of neuromuscular monitoring and the development of appropriate guidelines to reduce the risk of postoperative residual neuromuscular block.
The authors argue for the routine use of neuromuscular monitoring in anesthesia, contrasting its proven benefits with the unproven but universally accepted use of pulse oximetry.
To the Editor Pulse oximetry is nearly always used and accepted in the perioperative setting and is part of anesthesia guidelines globally. However, there is neither definitive evidence that its routine use reliably improves outcomes, effectiveness, and efficiency, nor that it reduces intensive care unit admissions or mortality in operative patients.1 In contrast to this universal application of a technology as yet unproven to improve outcome, Kotake et al.2 demonstrate the impact of not using neuromuscular monitoring (a technique about which many publications demonstrate improved outcomes) on the risk of postoperative residual neuromuscular block after reversal with sugammadex.3,4 It is past the time for anesthesiologists and anesthesia societies to develop appropriate guidelines for management of neuromuscular block including the choice of an appropriate neuromuscular blocking agent, adequate reversal when necessary, and recommending that neuromuscular monitoring equipment should be available and used for every patient in whom neuromuscular blocking drugs are used. Neuromuscular monitoring: welcome in the real world! Hans D. de Boer MD, PhD Department of Anesthesiology and Pain Medicine Martini General Hospital Groningen Groningen, the Netherlands [email protected] Leo HDJ Booij MD, PhD Department of Anesthesiology and Pain Medicine Radboud University Medical Center Nijmegen Nijmegen, the Netherlands
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Boer et al. (2014) conducted a letter in Postoperative residual neuromuscular block. Neuromuscular monitoring vs. No neuromuscular monitoring was evaluated. The authors advocate for the routine use of neuromuscular monitoring and the development of appropriate guidelines to reduce the risk of postoperative residual neuromuscular block.
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