2013 Volume 33 Issue 1 Pages 156-160
Clinical symptoms suggesting severe residual neuromuscular block such as diminished ability to breathe deeply and hold examiner's hands tight may occasionally be missed by anesthesiologists before tracheal extubation. Instead, unrecognized mild residual neuromuscular block defined as train-of-four (TOF) ratios between 0.7 and 0.9 may be clinically important and potentially cause upper airway obstruction. To prevent respiratory depression caused by residual neuromuscular block, it is essential to objectively evaluate the depth of neuromuscular block, administer an optimum dose of sugammadex and finally verify adequate recovery to a TOF ratio of 0.9.
