Monitoring techniques: neuromuscular blockade and depth of anaesthesia

Abstract

Monitoring has always played a pivotal role in anaesthesia. It reduces the risks of incidents or accidents by giving us early warning signs prior to their occurrence. Neuromuscular and depth of anaesthesia monitoring, once considered advanced monitoring techniques are now essential elements of our anaesthetic practice. This article describes peripheral nerve stimulators and the importance of different patterns of stimulation to quantify the degree of neuromuscular blockade. The article will also focus on electroencephalogram analysis and stimulated evoked potentials for assessment of depth of anaesthesia. The physical principles of these methodologies and their role and limitations within the clinical context will be discussed including the current clinical guidance and recommendations for neuromuscular blockade and depth of anaesthesia assessment.