[Management of neuromuscular block during general anesthesia : Results of a survey in Germany in 2020 compared to the recommendations of the first European guidelines in 2023].

Abstract

Since the last surveys on the utilization of muscle relaxants in general anesthesia in 2000 and 2005, it can be assumed that the introduction of sugammadex for the rapid and safe reversal of neuromuscular blocks as well as the establishment of new surgical techniques, have had an impact on the use of muscle relaxants in general anesthesia. A web-based questionnaire was used to survey anesthesia departments and outpatient surgery centers regarding the use of neuromuscular blocking agents. The aim was a comparison with previous surveys and the statistical analysis was descriptive. The response rate of the 1027 anesthesia departments contacted was 16.5%. The availability of neuromuscular monitoring in hospitals continues to improve. The most frequently used drug for rapid sequence induction is now rocuronium rather than succinylcholine. Sugammadex is now available as a drug in 86% of the responding anesthesia departments. The concept of complete relaxation for laparoscopic surgery called deep block is used by 60% of those surveyed. The results are analyzed and discussed in the context of the first European guidelines published in 2023 by the European Society of Anaesthesiology and Intensive Care (ESAIC). They show that with respect to the use of succinylcholine and the support by new surgical techniques have changed the management of neuromuscular block since the last surveys. The use of neuromuscular monitoring to control the management of muscle relaxation is still not standard in all hospitals, so that an additional patient risk cannot be ruled out.