Utilization of neuromuscular blocking agents and the assessment of blockade are highly variable from one anesthesia provider to the next. To standardize practice and knowledge, we will provide a refresh of the relevant physiologic and pharmacologic principles and nerd out on the science behind quantitative neuromuscular monitors.
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Now that the American Society of Anesthesiologists and European Society of Anaesthesiology have published Neuromuscular Blockade Practice Guidelines recommending the routine use of quantitative neuromuscular monitors, change is imminent. Most anesthesia providers only have access to peripheral nerve stimulators, meaning they’ll need to incorporate a new device into their workflow and an unfamiliar parameter into their clinical practice.
The evidence is sound, but it doesn’t make change less difficult. To ease the transition and aid adoption, we’ve created The Twitch, a blog repository for all things neuromuscular blockade monitoring. Having spent the past decade building quantitative neuromuscular monitors and helping anesthesia departments introduce them as a standard of care, we’ve learned a few things. We created this blog to share our knowledge, and the knowledge of colleagues who have been on the front lines of this change. Whether you’re wondering how a TOF ratio is calculated, or looking for systemwide implementation best practices, we’re hoping you’ll find the answers here.