Residual weakness from Paralytic use is a know and likely under-recognized problem during general anesthesia.
Monitoring of the degree of paralysis is sometimes difficult to do and produces less than wished for accuracy. The EPAD allows monitoring of the degree of paralysis at the NMJ using quantitative electromyography (compound motor action potentials).
Current recommendations for monitoring neuromuscular blockade include utilizing a quantitative measuring tool and achieving a train-of-four 4:1 waveform ratio of at least 0.90 (90%) prior to extubation (Lien and Kopman 2014).
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