This LO really is more directly applicable to the final exam. However, it certainly won’t hurt to think about this LO in the context of your pharmacology study. Just don’t expect this material to turn up in a primary MCQ.
T/F face mask ventilation almost always improves after the onset of neuromuscular blockade (Ref 1)
T/F ensuring complete / optimal paralysis is an important step during a difficult or failed intubation (Ref 2)
T/F Intraoperative nerve monitoring is inhibited by neuromuscular blockade (e.g. recurrent laryngeal nerve during thyroidectomy; facial nerve during parotidectomy). It will be necessary to ensure that the muscle relaxant has worn off by the time monitoring is needed. Using rocuronium means that a small dose of sugammadex can be used if required. (Ref 3)
T/F in an intubated patient with severe bronchospasm, maintaining neuromuscular blockade will help with ventilation by directly relaxing bronchial smooth muscle (Ref 4)
T/F Suxamethonium 0.5 mg/kg is usually used for ECT. This produces partial neuromuscular blockade, so that some seizure activity can be observed, but without any risk of injury to the patient. (Ref 5)
- Warters etal. The effect of neuromuscular blockade on mask ventilation. Anaesthesia, 2011; 66: 163-7
- Difficult Airway Society. Management of unanticipated difficult intubation in adults (Flowchart), 2015.
- Empis de Vendin etal. Recurrent laryngeal nerve monitoring and rocuronium: a selective sugammadex reversal protocol. World J Surg, 2017; 41: 2298-2303
- Kam & Power 3rd edition, page 29-30.
- Mirzakhani etal. Neuromuscular blocking agents for electroconvulsive therapy: a systematic review. Acta Anaesth Scand, 2012; 56: 3-16.