National practice with assessment and monitoring of neuromuscular blockade

The Food and Drug Administration, drug manufacturers, and critical care experts recommend using peripheral nerve stimulators (PNSs) to monitor depth of blockade when administering neuromuscular blocking agents (NMBAs). This study evaluates critical care nurses' practices regarding use of PNSs, identifies problems associated with their use, and determines other methods of assessing level of blockade to guide medication titration. Of respondents to a survey, 75% reported administering NMBAs for long-term use in their critically ill patients. In facilities using NMBAs, 63% monitored blockade level with aPNS. Because of practice disparities and monitoring problems, further education and research are needed to ensure adequate monitoring during NMBA administration.