Neuromuscular monitoring

Do you routinely use objective neuromuscular monitoring (e.g., EMG, AMG, MMG) in your daily practice?

• Yes

• No

Which of the following is the reason for using neuromuscular blocking agents adjunctively in general anaesthesia?

• To optimize the surgical field by inhibiting spontaneous ventilation

• To optimize the surgical field by relaxation of skeletal muscles

• To cause relaxation of skeletal muscles.

• To cause muscle paralysis

Which muscle group is MOST resistant to both depolarizing and non-depolarizing neuromuscular blocking agents?

• Extraocular muscles

• Pharyngeal muscles

• Vocal cords

• Adductor pollicis

Which of the following is considered an OBJECTIVE method of neuromuscular monitoring?

• 5-second head lift

• Visual assessment of muscle response

• Acceleromyography

• Single twitch stimulation

Which muscle is recommended by the ASA guidelines for neuromuscular monitoring?

• Orbicularis oculi

• Adductor pollicis

• Masseter

• Pharyngeal muscles

What is the primary shortcoming of Acceleromyography technology?

• Susceptibility to electrical interference

• Requirement for specialized equipment

• The need for considerable muscle movement to obtain a reliable signal

• Inaccurate measurement of residual neuromuscular blockade

In the context of neuromuscular monitoring, what defines supramaximal stimulation?

• Stimulation intensity just sufficient to evoke a measurable muscle response

• Stimulation intensity significantly above that required to activate all muscle fibers

• Stimulation delivered at a frequency of 50 Hz

• Stimulation that produces a tetanic contraction

Which stimulation pattern is primarily used to quantify the intensity of blockade during intense neuromuscular blockade?

• Train-of-four stimulation

• Double-burst stimulation

• Post-tetanic count stimulation

• Tetanic stimulation

According to the ASA guidelines, what minimum train-of-four (TOF) ratio should be achieved before extubation to help avoid residual neuromuscular blockade?

• 0.6

• 0.7

• 0.8

• 0.9

The characteristic of double-burst stimulation (DBS) response in partially blocked muscles is

• The second burst is stronger than the first

• Both bursts are of equal strength

• The second burst is weaker than the first

• There is no reliable difference in strength between the bursts