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Applied Clinical Education

Improving Recognition and Prevention of Residual Paralysis After Surgery: Case Examples of Monitoring and Reversal

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Overview / Abstract:

Target Audience
This activity has been designed to meet the educational needs of anesthesiologists and anesthesia providers.

Program Overview
Neuromuscular blocking agents (NMBAs) cause generalized paralysis of skeletal muscles and prevent involuntary movement during surgical procedures. Often, residual paralysis remains postoperatively—a phenomenon known as residual neuromuscular blockade (RNMB)—and is associated with both short- and long-term morbidity. Despite the risks associated with RNMB, methods to reduce its occurrence through monitoring and reversal are not applied universally in clinical practice.

Educational Objectives
After completing this activity, the participant should be better able to:

1. Recognize the prevalence and degree of morbidity and adverse events associated with RNMB in patients who have undergone general anesthesia for a surgical procedure.
2. Advocate for the consistent use of quantitative monitoring for RNMB.
3. Describe the appropriate use of NMBA reversal agents based on their mechanisms of action.


Oct 01, 2017


Nursing CNE, Pharmacy CPE, Physician CME, Physician Assistant CME


Journal, Monograph, Online

Credits / Hours

1.0 AMA PRA Category 1 Credit



Presenters / Authors / Faculty

Tong J. (TJ) Gan, MD, MHS, FRCA and Sorin J. Brull, MD, FCARCSI

Sponsors / Supporters / Grant Providers

Supported by an independent educational grant from Merck & Co., Inc.

Keywords / Search Terms

Applied Clinical Education Neuromuscular blocking agents, NMBAs, paralysis, skeletal muscles, residual neuromuscular blockade, RNMB, morbidity, NMBA reversal agents, general anesthesia, anesthesiologists, anesthesia providers, free credit, free CME, Free CE Free CE CME

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