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Anesthesiology Research and Practice
Volume 2016, Article ID 7284146, 6 pages
Research Article

Current Trends in Neuromuscular Blockade, Management, and Monitoring amongst Singaporean Anaesthetists

1Private Anaesthesia Practice, Wendy Teoh Pte. Ltd., Singapore
2College of Anaesthesiologists, Singapore
3School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia
4Anaesthetic Associates, Singapore

Received 6 June 2016; Accepted 27 September 2016

Academic Editor: Jean Jacques Lehot

Copyright © 2016 Wendy H. Teoh et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Introduction. This survey aimed to investigate the attitudes/practice pertaining the use, management, and monitoring of neuromuscular blockade amongst Singaporean anaesthetists. Methods. All specialist accredited anaesthetists registered with the Singapore Medical Council were invited to complete an anonymous online survey. Results. The response rate was 39.5%. Neuromuscular monitoring (NM) was used routinely by only 13.1% despite the widespread availability of monitors. 82% stated residual NMB (RNMB) was a significant risk factor for patient outcome, but only 24% believed NMB monitoring should be compulsory in all paralyzed patients. 63.6% of anaesthetists estimated the risk of RNMB in their own institutions to be <5%. 63.1% always gave reversal. Neostigmine was predominantly used (85.1%), with 28.2% using sugammadex at least sometimes, citing unavailability and high costs. However, 83.8% believed in sugammadex’s benefits for patients’ safety and >50% said such benefits may be able to offset the associated costs. Conclusions. There is a significant need for reeducation about RNMB, studies on local RNMB incidences, and strengthening of current monitoring practices and guidelines. Strategies are discussed. As NM monitors appear widely available and reversal of NMB standard practice, it is hopeful that Singaporean anaesthetists will change and strive for evidence-based best clinical practice to enhance patient safety.