Postoperative residual neuromuscular blockade after rocuronium: incidence and association with quantitative monitoring-a retrospective study

Abstract

Aims: In this retrospective observational cohort study, we estimated the incidence of postoperative residual neuromuscular blockade (RNMB) after rocuronium administration and examined its association with intraoperative quantitative neuromuscular monitoring (NMM) and reversal strategies. Methods: We analyzed 305 adults with American Society of Anesthesiologists (ASA) physical status I-III who received rocuronium under general anesthesia between January and April 2024. Patients were classified as monitored or unmonitored according to the attending anesthesiologist’s preference for NMM use. Train-of-four ratio (TOFR) was measured in the post-anesthesia care unit (PACU) using TOFscan® acceleromyography; RNMB was defined as TOFR