Neuromuscular Block in Anaesthetised Children
2025 ESAIC and ESPA Guidelines on neuromuscular block in anaesthetised children – Indications, monitoring and reversal
Neuromuscular blocking agents (NMBAs) are a common component of balanced anaesthesia that can be used at induction to facilitate airway management, and during maintenance to improve surgical conditions or ventilation. Data from the European APRICOT study showed that 60.8% of tracheal intubations were performed with a NMBA. Moreover, neuromuscular block (NMB) NMB is not always monitored in children, especially in neonates and infants, as illustrated by the same study, where only 16% of the children who had received a NMBA had neuromuscular monitoring; however, there is significant institutional variation. This picture appears to be similar in North America. Absence of monitoring has been reported to increase the risk of residual neuromuscular block and postoperative respiratory complications, or even recurarisation. The recent availability of paediatric electromyography-based monitors might contribute to a change in practice
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