Error Traps in Pediatric Neuromuscular Block
Authors' conclusion
Avoidance of these error traps requires systematic application of evidence-based practices, including routine use of quantitative neuromuscular monitoring and objective confirmation of recovery with a train-of-four ratio ≥ 0.9 prior to extubation.
Study context
- Population
- Children receiving NMBAs during anesthesia, particularly neonates and infants
- Outcome
- Error traps in pediatric NMB management
Main finding
As reported in the abstract
- Omission of NMBAs when optimal intubating conditions are required
- Failure to use quantitative neuromuscular monitoring
- Inappropriate or mistimed pharmacological reversal
- Failure to recognize and treat residual paralysis
- These errors contribute to a persistently high incidence of residual NMB and are associated with increased risk of postoperative respiratory complications
- Developmental pharmacokinetic and pharmacodynamic variability further amplifies these risks
- 4 major error traps identified
Original publication
Error Traps in Pediatric Neuromuscular Block. Paediatr Anaesth. Published 30 April 2026. doi:10.
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