Incidence of residual neuromuscular blockade and use of neuromuscular blocking agents with or without antagonists: A systematic review and meta-analysis of randomized controlled trials

Neuromuscular blocking agents (NMBAs) have revolutionized the field of anesthesiology as they facilitate airway management and ensure optimal surgical conditions. Despite their beneficial and ubiquitous use during surgery, delayed or partial recovery from NMBAs, referred to as residual neuromuscular...

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Bibliographic Details
Published in:Journal of clinical anesthesia 2020-09, Vol.64, p.109818-109818, Article 109818
Main Authors: Raval, Amit D., Uyei, Jennifer, Karabis, Andreas, Bash, Lori D., Brull, Sorin J.
Format: Article
Language:English
Subjects:
Airway management
Antagonist drugs
Clinical trials
Intubation
Literature reviews
Meta-analysis
Muscle contraction
Patients
Pediatrics
Studies
Surgery
Systematic review
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Summary:Neuromuscular blocking agents (NMBAs) have revolutionized the field of anesthesiology as they facilitate airway management and ensure optimal surgical conditions. Despite their beneficial and ubiquitous use during surgery, delayed or partial recovery from NMBAs, referred to as residual neuromuscular block (rNMB), is a common clinical problem. While it is well accepted that the antagonist sugammadex, compared to neostigmine, can more rapidly reverse rocuronium-induced NMB regardless of depth of block, the occurrence of rNMB for routinely used combinations of NMBAs with sugammadex or neostigmine has not yet been quantified or evaluated systematically. We conducted a systematic literature review and meta-analysis of randomized controlled trials (RCTs) to quantify and compare the incidence of rNMB [defined as train-of-four ratio (TOFR)
ISSN:0952-8180
1873-4529
DOI:10.1016/j.jclinane.2020.109818