2023 Volume 43 Issue 4 Pages 283-289
The monitoring guidelines of the Japanese Society of Anesthesiologists revised in 2019 recommend mandatory use of neuromuscular monitoring devices when muscle relaxants are used. We conducted a retrospective observational study to determine whether campaigns for routine use of neuromuscular monitoring device led to appropriate management of muscle paralysis during emergence from anesthesia in 267 adult patients who received rocuronium for scheduled anesthesia and surgery over a 28 month period at our university hospital. Although the campaigns significantly and progressively improved both usage rate of neuromuscular monitoring devices during induction of anesthesia（56% to 94%）and the appropriate muscle paralysis management rate（38% to 64%）, anesthesiologists failed to properly restore muscle strength in one-third of patients even at the end of the campaigns due to insufficient doses of sugammadex and determination of sugammadex dose without information from neuromuscular monitoring. These findings suggest that the use of neuromuscular monitoring devices alone may not ensure complete recovery of muscle strength in patients receiving muscle relaxant during anesthesia and surgery.
