Postoperative residual curarization (PORC) or residual neuromuscular blockade (RNMB) is a residual paresis after emergence from general anesthesia that may occur with the use of neuromuscular-blocking drugs. Today residual neuromuscular blockade is defined as a train of four ratio of less than 0.9 when measuring the response to ulnar nerve stimulation at the adductor pollicis muscle using mechanomyography or electromyography. A meta-analysis reported that the incidence of residual neuromuscular paralysis was 41% in patients receiving intermediate neuromuscular blocking agents during anaesthesia. It is possible that > 100,000 patients annually in the USA alone, are at risk of adverse events associated with undetected residual neuromuscular blockade.Neuromuscular function monitoring and the use of the appropriate dosage of sugammadex to reverse blockade produced by rocuronium can reduce the incidence of postoperative residual curarization. In this study, with usual care group receiving reversal with neostigmine resulted in a residual blockade rate of 43%.
^Ortega, Rafael; Brull, Sorin J.; Prielipp, Richard; Gutierrez, Alexander; De La Cruz, Rossemary; Conley, Christopher M. (2018-01-25). "Monitoring Neuromuscular Function". New England Journal of Medicine. 378 (4): e6. doi:10.1056/nejmvcm1603741. ISSN0028-4793. PMID29365307.
^Naguib, M.; Kopman, A.F.; Ensor, J.E. (2007). "Neuromuscular monitoring and postoperative residual curarisation: a meta-analysis". British Journal of Anaesthesia. 98 (3): 302–316. doi:10.1093/bja/ael386. ISSN0007-0912.
^Brueckmann, B.; Sasaki, N.; Grobara, P.; Li, M.K.; Woo, T.; de Bie, J.; Maktabi, M.; Lee, J.; Kwo, J. (November 2015). "Effects of sugammadex on incidence of postoperative residual neuromuscular blockade: a randomized, controlled study". British Journal of Anaesthesia. 115 (5): 743–751. doi:10.1093/bja/aev104. ISSN0007-0912.