There is mounting evidence that residual neuromuscular blockade and clinical weakness occur with disturbing frequency, even when the patient has received only one dose of an intermediate-duration nondepolarizing relaxant. These residual effects have been noted even 2 hours after a single dose. Part of the problem appears to be subjective misinterpretations of full return of TOF as discussed earlier. It appears that routine reversal of all patients might be a prudent practice. How sugammadex changes anesthetic practice remains to be determined.
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