Post-operative residual paralysis is an under-recognized event. Monitoring the effects of neuromuscular blocking drugs ensures their appropriate intra-operative use and helps prevent residual neuromuscular weakness.
The accepted definition for “adequate recovery” from neuromuscular block is the return of the train-of-four (TOF) ratio to, or above 0.9 (90%). This level of recovery restores most of the functional integrity of the muscles involved in airway protection.
The only reliable way of confirming adequate recovery from neuromuscular blockade and avoiding postoperative residual weakness is quantitative neuromuscular monitoring.