title: Neuromuscular block in Italy: a survey of current management.
abstract: BACKGROUND
  Little is known about current use of neuromuscular blocking agents by Italian anesthetists. This paper reports the results of a survey conducted to obtain information about current management of neuromuscular block in Italy.
  
  
  METHODS
  A questionnaire was given to Italian Anesthetists attending the 64nd National Congress of the Italian Society of Anesthesia, Intensive Care, Analgesia and Intensive Therapy S.I.A.A.R.T.I. (Parma, 13th-16th October 2010). Collected data were stratified by age, geographical location, and the total number of surgical procedures performed in the hospitals concerned.
  
  
  RESULTS
  One thousand four hundred forty patients correctly compiled questionnaires were collected. 50% of respondents used clinical tests to monitor the level of neuromuscular blockade. The main clinical tests cited for the evaluation were: keeping the head lifted up for 5 seconds, protruding the tongue and opening the eyes. Train-of-four was used by 50% of respondents on a routine basis. Only 33% of anesthetists reply that a train-of-four ratio of 90% or more is the safe level prior to extubation.
  
  
  CONCLUSIONS
  Clinical signs are used by most of the Italian anesthetists to assess the recovery from neuromuscular blockade. There is poor awareness about their inability to indicate even a significant degree of residual neuromuscular block. A more extensive use of quantitative instrumental monitoring is required for the more rational use of neuromuscular blocking agents.
authors.affiliation: Clinic of Anesthesia and Resuscitation, School of Specialization in Anesthesia and Resuscitation, Udine University Hospital, Udine, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Della Rocca
authors.forename: F
authors.initials: F
authors.lastname: Iannuccelli
authors.forename: L
authors.initials: L
authors.lastname: Pompei
authors.forename: P
authors.initials: P
authors.lastname: Pietropaoli
authors.forename: C
authors.initials: C
authors.lastname: Reale
authors.forename: P
authors.initials: P
authors.lastname: Di Marco
mesh_terms: D004363:Drug Utilization / Q000706:statistics & numerical data; D004558:Electric Stimulation; D019538:Health Care Surveys; D006801:Humans; D007558:Italy; D016343:Monitoring, Intraoperative; D019148:Neuromuscular Blockade / Q000706:statistics & numerical data*; D009466:Neuromuscular Blocking Agents; D020127:Recovery of Function; D011795:Surveys and Questionnaires
chemical_list: D009466:Neuromuscular Blocking Agents