A Survey of the Society for Pediatric Anesthesia on the Use, Monitoring, and Antagonism of Neuromuscular Blockade

This review also includes:

Renew JR, Tobias JD, Brull SJ. The Time to Seriously Reassess the Use and Misuse of Neuromuscular Blockade in Children Is Now. Anesth Analg. 2021;132(6):1514-1517. doi:10.1213/ANE.0000000000005488

Study Type: Survey of SPA members with 13% response rate

Methods: Survey

Findings: Responding paediatric anaesthesiologists aren’t very thorough at monitoring NMB (older = worse), use sugammadex more frequently if they’re younger, and don’t mention the potential interference with oral contraceptive efficacy to postmenarchal females.

Commentary: This study is accompanied by an editorial by Renew et al. (with a mild conflict of interest, that is disclosed) that takes the survey findings and runs with them forcefully. The editorial strongly critiques practitioners who don’t monitor NMB quantitatively, and places most of the blame on the ease of use of sugammadex. It’s worth reading itself. Within the forceful encouragement for us to use quantitative NMT monitoring is a mild absence of evidence that this more relaxed (excuse the pun) approach comes with significant real-world issues. I’m rethinking my approach to such monitoring as a consequence of reading these papers……

Reviewed by Dr Justin Skowno