The use of neuromuscular monitoring in Germany

Abstract

As there are no reliable epidemiological data for the use of muscle relaxants in Germany,we conducted a mailing study. The aim of the study was to compare the use of muscle relaxants between German anaesthesia departments. In the present part of the presentation we focused on neuromuscular monitoring (NMM) and management of residual paralysis. A total number of 2,996 questionnaires were sent to all registered anaesthesiological facilities in Germany and the return was 68.6% (2054 questionnaires). In 574 of the returned questionnaires (28%) the regular use of NMM was confirmed. Intraoperative monitoring of neuromuscular block and assessment of neuromuscular recovery were the most frequent applications of NMM, i.e. 25% and 18% of returned questionnaires, respectively. Clinical signs, however, are still the most popular way to estimate the degree of neuromuscular blockade. Moreover, routine reversal at the end of surgery with a neostigmin/atropine mixture was not practiced in 75% of the anaesthesia departments. This survey revealed that NMM is still very rarely used in daily clinical practice. Especially the seldom use of NMM to assess residual paralysis has to be improved.