Neuromuscular monitoring with a peripheral nerve stimulator can be helpful in preventing complications during the perioperative period when neuromuscular blocking agents are used..


Indications related to use of neuromuscular drugs:

(1) continuous infusion of a neuromuscular blocking agent

(2) injection of a long-acting muscle relaxant

(3) need to avoid drug-induced reversal of neuromuscular blockade because of underlying disease (asthma, heart disease, etc.)


Indications related to the patient:

(1) presence of a neuromuscular disease such as myasthenia which may affect drug pharmacodynamics

(2) presence of a condition that requires maximal respiratory muscle function as soon as possible during recovery (morbid obesity, severe pulmonary disease)

(3) condition resulting in abnormal drug kinetics for muscle relaxants

(3a) very young or very old

(3b) severe liver disease

(3c) severe kidney disease

(3d) other severe illness


Indications related to the procedure:

(1) prolonged surgical procedure


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