Residual neuromuscular blockade after anesthesia: a possible cause of postoperative aspiration-induced pneumonia.

260 February 2014 P aspiration is rare during daily life, thanks to amazingly well-organized protective mechanisms, such as swallowing (and coordinated cessation of breathing during swallowing), coughing, and laryngeal closure.1 If any part of these mechanisms is impaired, the risk of aspiration increases. In this issue of ANesthesIOLOgY, hårdemark Cedborg et al.2 have shown that in asymptomatic elderly people, pharyngeal function is often impaired, and that residual effect of a neuromuscular-blocking agent after general anesthesia would worsen the impairment. The research group extended their previous works performed in healthy young volunteers3–5 and provides physiological evidence for partial paralysis as a possible cause to postoperative aspiration-induced pneumonia in elderly people.