Understanding Anesthesiology - The Global Regional Anesthesia ...

Residual block
Residual block (or residual paralysis) refers to the patient who displays the ongoing effects
of non-depolarizing muscle relaxants (NDMR) on or after emergence. It can occur when excessive
doses of NDMR are given intraoperatively, or if appropriate antagonism (with anticholinesterases)
has not occurred.
Some factors predispose to residual block and include an unexpectedly short duration of surgery
or inadequate renal or hepatic function required to metabolize the NDMR.
The use of a peripheral nerve stimulator as well as clinical examination of the patient on
emergence should identify a residual block. If possible, an additional dose of anticholinesterase
can be given. If the residual block is significant and/or the maximum dose of anticholinesterase
has been given, then the patient should remain intubated, with appropriate sedation,
until normal muscle strength returns.
Extubating a patient with a residual block puts the patient at risk of airway obstruction, laryngospasm,
aspiration and inadequate ventilation.
Related Glossary Terms
Airway obstruction, Anticholinesterase, Cholinesterase, Emergence, Extubation, Laryngospasm,
Non-depolarizing muscle relaxants, Peripheral nerve stimulator
Index
Find Term
Chapter 3 - General Anesthesia
Chapter 4 - Recovery