[Show abstract][Hide abstract] ABSTRACT: Satisfactory recovery from nondepolarizing neuromuscular block is currently defined as return of the train-of-four ratio at the adductor pollicis muscle to a value of 0.90 or greater. Studies in volunteers demonstrate that train-of-four ratios of 0.70–0.80 are associated not only with subjective symptoms of weakness, but also dysfunction of the muscles of airway patency and swallowing. There is ample evidence that a sizeable proportion of patients who receive nondepolarizing neuromuscular blocking agents return to postanesthesia care units with undetected postoperative residual neuromuscular block (postoperative muscle weakness). However, until recently, outcome studies that demonstrate that postoperative weakness may be associated with adverse patient outcomes have been lacking. This review is an attempt to collate the available data that suggest that even modest levels of residual block have untoward clinical consequences.
[Show abstract][Hide abstract] ABSTRACT: The set of guidelines for good clinical research practice (GCRP) in pharmacodynamic studies of neuromuscular blocking agents, which was developed following an international consensus conference in Copenhagen, has been revised and updated following the second consensus conference in Stockholm in 2005. It is hoped that these guidelines will continue to help researchers in the field and assist the pharmaceutical industry and equipment manufacturers in enhancing the standards of the studies they sponsor.
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