The American Society of Anesthesiologists (ASA) and the European Society of Anaesthesiology and Intensive Care (ESAIC) recently published, independently from one another, their respective Practice Guidelines for the Management of Neuromuscular Blockade.1,2 The ASA guideline provides evidence-based recommendations regarding appropriate monitoring and antagonism of neuromuscular blockade. The ESAIC guideline presents aggregated and evidence-based recommendations regarding the role of neuromuscular blocking agents to facilitate airway management and to improve surgical conditions, as well as strategies for the diagnosis and prevention of residual paralysis. Both societies’ guidelines recommend the use of quantitative neuromuscular monitoring at the adductor pollicis to guide antagonism. Accordingly, sugammadex is recommended for deep, moderate, and shallow levels of neuromuscular blockade that is induced by rocuronium or vecuronium; neostigmine is a reasonable alternative for minimal blockade; and patients with a calibrated and normalized train-of-four ratio greater than or equal to 0.9 do not require pharmacologic antagonism....
Joint Letter to the Editor from the American Society of Anesthesiologists and the European Society of Anaesthesiology and Intensive Care on Management of Neuromuscular Blockade
This Letter is being published concurrently online and in the September 2023 issue (Volume 139, Number 3) of Anesthesiology and the September 2023 issue (Volume 40, Number 9) of European Journal of Anaesthesiology.
(Accepted for publication May 19, 2023. Published online first on June 2, 2023.)
Thomas Fuchs-Buder, Edoardo De Robertis, Stephan R. Thilen, Michael W. Champeau; Joint Letter to the Editor from the American Society of Anesthesiologists and the European Society of Anaesthesiology and Intensive Care on Management of Neuromuscular Blockade. Anesthesiology 2023; 139:366–367 doi: https://doi.org/10.1097/ALN.0000000000004630
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