Should all patients who receive nondepolarizing relaxants be reversed

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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