Anesth Pain Med.  2019 Oct;14(4):441-448. 10.17085/apm.2019.14.4.441.

Current use of neuromuscular blocking agents and antagonists in Korea: a 2018 survey

• Kim JS
• Han JW
• Lee JH
• Choi JM
• Kim HJ
• Sung TY
• Kim YB
• Shin YS
• Yang HS

• KMID: 2465343
• DOI: http://doi.org/10.17085/apm.2019.14.4.441

Abstract

BACKGROUND
Neuromuscular blocking agents (NMBAs) and neuromuscular monitoring in anesthetic management are integral for endotracheal intubation, better visualization of the surgical field, and prevention of residual neuromuscular blockade and pulmonary complications. Sugammadex is a drug that reduces risk of residual neuromuscular blockade, with more rapid recovery compared to anticholinesterase. The purpose of this study was to investigate current usage status of NMBAs and antagonist with neuromuscular monitoring, among anesthesiologists in Korea.
METHODS
Anesthesiologists working in Korea were invited to participate in an online survey via email January 2-February 28, 2018. The questionnaire consisted of 45 items, including preferred NMBAs, antagonists, neuromuscular monitoring, and complications related to the use sugammadex. A total of 174 responses were analyzed.
RESULTS
Rocuronium was a commonly used NMBA for endotracheal intubation (98%) of hospitals, and maintenance of anesthesia (83.3%) in of hospitals. Sugammadex, pyridostigmine, and neostigmine were used in 89.1%, 87.9%, and 45.4% of hospitals. Neuromuscular monitoring was employed in 79.3% of hospitals; however only 39.7% of hospitals used neuromuscular monitoring before antagonist administration. Usual dosage range of sugammadex was 2.1-4 mg/kg in 35.1% of hospitals, within 2 mg/kg in 34.5% of hospitals, and 1 vial regardless of body weight in 22.4% of hospitals. Sugammadex-related complications were encountered by 14.9% of respondents.
CONCLUSIONS
This survey indicates several minor problems associated with the use of antagonists and neuromuscular monitoring. However, most anesthesiologists appear to have appropriate information regarding the usage of NMBAs and sugammadex.

Keyword

Neostigmine; Neuromuscular blocking agents; Neuromuscular monitoring; Pyridostigmine bromide; Sugammadex

MeSH Terms

Anesthesia
Body Weight
Delayed Emergence from Anesthesia
Electronic Mail
Intubation, Intratracheal
Korea*
Neostigmine
Neuromuscular Blockade*
Neuromuscular Blocking Agents*
Neuromuscular Monitoring
Pyridostigmine Bromide
Surveys and Questionnaires
Neostigmine
Neuromuscular Blocking Agents
Pyridostigmine Bromide

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