Residual Neuromuscular Blockade: An Insidious Risk By Uday Jain, MD, PhD, FASA P ostoperative residual neuromuscular blockade (NMB) is an important safety concern in anesthesia care. The incidence of residual NMB has been reported to be as high as 63.5%.1 The problems due to residual NMB are listed in Table 1.2-5 In surgery centers with limited recovery facilities, it is critical to adequately reverse NMB. Residual NMB is especially detrimental to home bound patients. Table 1. Problems due to residual neuromuscular blockade Generalized weakness Airway obstruction Impaired swallowing & coughing - aspiration, pneumonia Shallow breathing Inability to speak & smile Eye closure, blurred & double vision Patient distress- agitation, hypertension, tachycardia Increased length of stay (continued) Annual Publication 2017 | 67