Reversal of Neuromuscular Blockade.
Reversal of Neuromuscular Blockade.
One new RCT corroborates findings reported in the original ASA Guidelines regarding the efficacy of edrophonium to antagonize the effects of neuromuscular blocking agents (e.g., rocuronium, cisatracurium, rapacuronium) when compared with spontaneous recovery (Category A3-B evidence).The original Guidelines indicated that neostigmine is effective for the antagonism of residual neuromuscular blockade (Category A1-B evidence); new literature is insufficient to further evaluate these findings. The original Guidelines reported an increased frequency of postoperative emetic episodes with the use of neostigmine (Category A1-H evidence); new literature is insufficient to further evaluate this finding. The literature continues to be insufficient to evaluate the occurrence of other complications associated with either edrophonium or neostigmine.
The consultants and ASA members are equivocal regarding whether anesthetic regimens designed to avoid the need for antagonism of neuromuscular blockade reduce adverse outcomes or improve patient comfort and satisfaction.
