Reversal of Neuromuscular Blockade Based on Train of Four Response: a Prospective Randomized Controlled Trial

Background and aims: Use of neostigmine to reverse the non-depoloarizing neuromuscular block at end surgery is a standard practice. Reversal with based on body weight still commonly followed. However, may affect adversely if used empirically in absence residual blockade. This study compares empirical technique reversal using dose adjusted train-of-four (TOF) response. Methods: prospective, double-blinded, randomized controlled trial included 126 patients undergoing under general anaesthesia, lasting for >1 hour. They were into group control receiving (0.05 mg/kg neostigmine) determined by TOF Signs paralysis after extubation observed. ratios/count, time, side-effects agent also noted. Results: Patient characteristics comparable both groups. Number signs weakness was less (26/63), but (40/63, p=0.094). TOF≥0.9 significantly high (40/63) than (22/63), number count <4 (17/63 vs 8/63). Overall ratio extubation, reversal-extubation time taken reach 0.9 comparable. Conclusion: respect postoperative weakness, side effects agent.