Residual Neuromuscular Blockade in Critical Care

medication duration and length and type of surgery. RNMB is more prevalent in patients with renal impairment than in patients with normal kidney function.2,3 To man-age and assess patients who received NMBAs during surgery or other procedures requires nurses to under-stand the current evidence on poten-tial complications associated with these agents. NMBAs blunt or abolish the neuromuscular protective reflexes of coughing, gagging, and blinking. In the immediate period after anes-thesia, this loss of muscular strength can lead to aspiration, impaired ventilatory response to hypoxia, and obstruction of the upper part of the airway.2 Long duration of anesthesia and problems with metabolism and excretion of the medications can also result in prolonged duration of mechanical ventilation and longer stays in the critical care unit.2,8 RNMB is an important clinical con-cern after anesthesia because of the vulnerability of the patients to adverse postoperative events. The priority in caring for patients with RNMB is recognition, monitoring, and intervention to ensure optimal outcomes. In this article, we describe the mechanisms of action of NMBAs