Reversal of Neuromuscular Blockade - Part 1 of 2


Manage episode 240149899 series 2529779
By David Hao, MD, David Hao, and MD. Discovered by Player FM and our community — copyright is owned by the publisher, not Player FM, and audio is streamed directly from their servers. Hit the Subscribe button to track updates in Player FM, or paste the feed URL into other podcast apps.

We explore three claims about reversal of neuromuscular blockade.

1. Location of train-of-four assessment matters

2. Train-of-four is unnecessary with "sufficient" time from the last dose

3. Fade can be discriminated by tactile assessment

Our guest today is Dr. Daniel Saddawi-Konefka of the Massachusetts General Hospital.

Full show notes available at

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Arain Sr, Kern S, Ficke DJ, Ebert TJ. Variability of duration of action of neuromuscular blocking drugs in elderly patients. Acta Anaesthesiol Scand. 2005;49:312–315.

Caldwell JE. Reversal of residual neuromuscular block with neostigmine at one to four hours after a single intubating dose of vecuronium. Anesth Analg 1995;80:1168 –74

JØRGEN VIBY-MOGENSEN, NIELS HENRIK JENSEN, JENS ENGBAEK, HELLE ØRDING, LENE THEIL SKOVGAARD, BENT CHRAEMMER-JØRGENSEN; Tactile and Visual Evaluation of the Response to Train-of-four Nerve Stimulation. Anesthesiology1985;63(4):440-442.

Stephan R. Thilen, Bradley E. Hansen, Ramesh Ramaiah, Christopher D. Kent, Miriam M. Treggiari, Sanjay M. Bhananker; Intraoperative Neuromuscular Monitoring Site and Residual Paralysis. Anesthesiology 2012;117(5):964-972. doi: 10.1097/ALN.0b013e31826f8fdd.


7 episodes