Release Date: October 10, 2013
Expiration Date: September 30, 2015


  • Jon Gould, MD

    Chief, Division of General Surgery
    Alonzo P. Walker Chair in Surgery
    Professor of Surgery
    Medical College of Wisconsin
    Senior Medical Director of Clinical Affairs
    Froedtert Hospital
    Milwaukee, Wisconsin
  • Glenn S. Murphy, MD

    Clinical Professor, Anesthesiology
    University of Chicago Pritzker School of Medicine
    Cardiac Anesthesia and Clinical Research
    NorthShore University HealthSystem
    Evanston, Illinois


The goal of this activity is to educate physicians and other clinicians about strategies to minimize residual paralysis following neuromuscular blockade (NMB) in surgery.

Learning Objectives

  1. Describe the rationale for NMB, including potential benefits in specific surgery types.
  2. Review the benefits and drawbacks of available neuromuscular blocking agents (NMBAs).
  3. Outline approaches to NMB reversal, including investigational agents.

Intended Audience

The intended audience for this educational activity includes anesthesiologists, surgeons, and other clinicians who are involved with the care of patients undergoing surgery with NMB.

Statement of Need

Incomplete neuromuscular recovery has been observed in a large percentage of postanesthesia care patients, particularly in those with critical respiratory events. The residual effects of NMBAs can contribute to adverse respiratory events and other morbidity. Data suggest that clinicians lack knowledge relating to the clinical assessment of neuromuscular recovery and that monitoring of blockade perioperatively is infrequent at best; objective monitoring generally is not performed. Improved management of the NMB requires a current knowledge of issues associated with the use of NMBAs (eg, administration of specific agents, early reversal, use of quantitative neuromuscular monitoring). Having an up-to-date knowledge of these issues and management techniques may reduce the incidence of residual NMB and attendant complications in the early postoperative period.

Estimated Time for Completion

1 hour

Course Format

Interactive monograph

Accreditation Statement

This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Global Education Group and Applied Clinical Education. Global Education Group is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation

Global Education Group designates this activity for a maximum of 1.0 AMA PRA Category 1 Creditâ„¢. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This program has been prior approved by the American Association of Nurse Anesthetists for 1.0 CE Credits; Code Number 1030792; Expiration Date 9/30/2015.

Instructions to receive credit

To receive CME credit, participants should read the preamble, complete the pre-test, read the monograph, and complete the post-test and activity evaluation. Participants must score at least an 80% on the post-test to be awarded credit. Certificates of completion will be electronically issued immediately upon successful completion. Retesting is not allowed.


There are no fees for participating in or receiving credit for this activity.

Disclosure of Conflicts of Interest

Global Education Group requires instructors, planners, managers, and other individuals and their spouses/life partners who are in a position to control the content of this activity to disclose any real or apparent conflicts of interest they may have as related to the content of this activity. All identified conflicts of interest are vetted thoroughly by Global Education Group for fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations.

The faculty reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this activity:
Glenn S. Murphy, MD: Merck (consultant/independent contractor, speakers' bureau)
Jon Gould, MD: Nothing to disclose

The planners and managers reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this activity:
Michael Vlessides: Nothing to disclose
Jennifer Kulpa: Nothing to disclose
Ashley Marostica, RN, MSN: Nothing to disclose
Amanda Glazar, PhD: Nothing to disclose

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. Global Education Group and Applied Clinical Education do not recommend the use of any agent outside of the labeled indications. The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of any organization associated with this activity. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.


Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or courses of diagnosis or treatment discussed should not be used by clinicians without evaluation of patient conditions, contraindications, applicable manufacturer's product information, and the recommendations of other authorities.


Accreditor Contact Information

For information about the accreditation of this program, please contact Global Education Group at (303) 395-1782 or

System Requirements


  • Microsoft Windows 2000 SE or greater
  • Flash Player Plugin (v7.0.1.9 or greater)
  • Internet Explorer (v5.5 or greater) or Firefox Adobe Acrobat Reader


  • MAC OS 10.2.8 Flash Player Plugin (v7.0.1.9 or greater)
  • Safari Adobe Acrobat Reader
  • Internet Explorer is not supported on the Macintosh
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