Management of Neuro-Muscular Blocking

Scientific Faculty
Host
Prof Teodora O Nicolescu
ESAIC eLearning Committee member

Dept of Anaesthesiology, Oklahoma University Health Sciences Center



Speakers
Prof. Thomas Fuchs-Buder
Departement Anaesthesiology

University of Lorraine, Nancy, France



Dr Vitor Pinho-Oliveira
Hospital CUF Viseu

C.H. Tondela-Viseu, Viseu, Portugal



Management of neuromuscular blockade is a pivotal skill for modern clinical anaesthesia practice that came across as profound advancement. Neuromuscular blocking agents (NMBAs), usually administered to facilitate endotracheal intubation and/or to improve surgical conditions can aid in mechanical ventilation in patients with poor lung compliance.

While mostly used in the operating room environment, we should not underscore their importance in the ICU setting as well. The neuromuscular blockade should be monitored for all patients who receive NMBAs during anaesthesia, to guide discontinuation of them as well as reversal agents, and to assess the degree of recovery. Clinical implications of residual neuromuscular block, still frequent in clinical practice, are important risk factors in anaesthetic-related morbidity and mortality.

On this webinar, starting from an interactive clinical case discussion, we will discuss the clinical use and pharmacology of commonly used NMBAs, their reversal agents, methods for neuromuscular blockade monitoring as well as clinical implications and strategies to prevent postoperative residual neuromuscular block.



Target Audience
Anaesthesiologists, Intensive Care Medicine doctors, Surgeons (either specialists or residents) or any healthcare professional who wants to update their knowledge about neuromuscular blockade management in clinical anaesthesia practice.
This webinar will be open to anyone who wishes to view it, from whichever country they can access it.


Methods to promote adult active learning
This webinar will include:

Polls: to increase interactivity and engagement. Results from polls will lead to discussions points during each lecture.
Q&A session at the end of the webinar: to answer questions brought up by the host and submitted by the audience (in real-time). Questions will be filtered by scientific support to prioritise relevance.


Learning Aim
To acquire relevant information on the clinical management of neuromuscular blockade management for current anaesthetic practice
To understand the incidence, pathophysiology and clinical consequences of residual paralysis
To understand the link between depth of neuromuscular blockade and patient outcome


After Taking Part
This webinar will enable the participants to:

Discuss clinical pharmacology of NMBAs and their reversal agents currently used in a clinical setting;
Recognize the importance of adequate neuromuscular blockade monitoring emphasizing the role of quantitative monitoring methods;
To acknowledge clinical implications and strategies to prevent postoperative residual neuromuscular block.


Key points
Neuromuscular junction physiology;
Neuromuscular blocking agents (depolarizing/non-depolarizing) and reversal agents;
Neuromuscular blockade monitoring (clinical, qualitative, quantitative methods);
Postoperative residual neuromuscular block


Content
Clinical Case:
Male, 68y, admitted to OR for an urgent laparotomy for suspect gastrointestinal occlusion, with fecaloid vomiting, signs of difficult airway (obesity, beard, stiff neck, loose teeth)
Poll#1:
On adequate neuromuscular blockade management: agent (ROC/SUX?); NMB monitoring
Lecture #1:
NM junction physiology, NMBAs, Reversal Agents, NMB monitoring;
Lecture #2:
Postoperative residual neuromuscular block: clinical implications and strategies to prevent it
Lecture#3 (?):
The future of neuromuscular blockade management
Discussion
Wrap up: mini journal club on “my landmark paper on neuromuscular management”


Learning Objectives
Knowledge to be acquired after attending this Webinar

The participant will be able to:

Identify the pharmacological characteristics of neuromuscular blocking and reversal agents
Describe methods of neuromuscular monitoring their advantages/disadvantages
Apply knowledge to practical skills of identifying residual neuromuscular blockade


Practical skills to be acquired after attending this Webinar

This webinar will enable participants to:

Manage adequately neuromuscular blocking agents
Interpret signs of residual neuromuscular blockade
Review pharmacological concepts


Affective skills acquired after attending this Webinar

The participant is aware of:

Align the newest evidence guidelines and practice skills
Recall neuromuscular blocking agents monitoring techniques
Compare neuromuscular blocking and reversal agents efficacy and cost


Technical Settings
This webinar is available on PC, Tablet and smartphones.

For the best viewing experience, a high-speed internet connection is required.