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Significantly prolonged neuromuscular blockade after a single dose of rocuronium: The importance of monitoring.

Postoperative residual curarisation (PORC) continues to be a common problem in modern anaesthesia. An incidence of 26% was registered in a Portuguese multicentre study published in 2013. Residual paralysis is associated with impaired pharyngeal function and increased risk of aspiration, airway obstruction, attenuation of the hypoxic ventilatory response and symptoms of muscle weakness. As PORC is associated with clinical adverse events, all efforts must be made to reduce it. Quantitative monitoring of neuromuscular (NM) function after neuromuscular blockade (NMB) has been indicated as the best way to avoid it. In addition, the results of the National Audit Project 5 demonstrate that a significant proportion of cases of accidental awareness occur during emergence from anaesthesia, supporting the routine use of monitoring NM function during that phase of anaesthesia.