{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T05:53:36Z","timestamp":1791266016018,"version":"4.1.0"},"reference-count":21,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T00:00:00Z","timestamp":1786752000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T00:00:00Z","timestamp":1786752000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Neuromuscular blocking agents are recommended by the European Society of Anaesthesiology and Intensive Care (ESAIC) and European Society of Paediatric Anaesthesia (ESPA) for facilitating tracheal intubation in children. Despite these recommendations, real\u2010world data on how neuromuscular blocking agents are used, monitored, and reversed remain scarce.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To identify and characterize self\u2010reported neuromuscular blocking agent practice patterns across European and non\u2010European countries, in the period preceding publication of the joint ESAIC and ESPA guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted an anonymous, cross\u2010sectional survey between 12 November and 12 December 2025, targeting members of the ESAIC, ESPA, and the French and Spanish national pediatric anesthesiology societies involved in pediatric airway management across 43 countries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The survey was accessed by 904 persons, and 874 responses were included in the analysis. Most participants were from Europe (83.5%) and worked in mixed pediatric anesthesia and intensive care settings (71.2%). Rocuronium was the most frequently used neuromuscular blocking agent for both routine tracheal intubation (68%; 95% CI 65%\u201371%) and rapid sequence intubation (67%; 95% CI 64%\u201370%). Neuromuscular blocking agents were used \u201calways\u201d or \u201cmostly\u201d before routine intubation in 47% of neonates (\u2264\u200930\u2009days) and 50% of infants (&lt;\u20091\u2009year), whereas \u201crarely\u201d or \u201cnever\u201d use was reported in 30% and 24%, respectively. Most respondents (56%) assessed adequacy of neuromuscular block using a fixed time interval after neuromuscular blocking agent administration. Reversal was administered \u201calways\u201d before extubation by 27% of respondents, while 9.3% reported \u201crarely\u201d and 2.9% \u201cnever.\u201d Only half of participants used quantitative neuromuscular monitoring to guide reversal. Sugammadex was used by 47%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Self\u2010reported clinical practice regarding neuromuscular blocking agent use in pediatric patients remains heterogeneous. Children are frequently intubated without neuromuscular blocking agents and extubated without consistent reversal. Quantitative neuromuscular monitoring remains uncommon. These practice patterns raise concerns for patient safety.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pan.70285","type":"journal-article","created":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T11:11:24Z","timestamp":1786792284000},"page":"1437-1448","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Current Use, Monitoring and Reversal of Neuromuscular Block in Pediatric Anesthesia and Intensive Care: A Web\u2010Based Cross\u2010Sectional\n                    <scp>ESAIC<\/scp>\n                    Survey"],"prefix":"10.1002","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2290-7749","authenticated-orcid":false,"given":"Giulia","family":"Bonatti","sequence":"first","affiliation":[{"name":"Unit for Research in Anaesthesia IRCCS Istituto Giannina Gaslini  Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9319-0807","authenticated-orcid":false,"given":"Mirjana","family":"Gander","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5117-9715","authenticated-orcid":false,"given":"Arash","family":"Afshari","sequence":"additional","affiliation":[{"name":"Department of Paediatric and Obstetric Anaesthesia, Juliane Marie Centre, Rigshospitalet &amp; Institute of Clinical Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9670-8588","authenticated-orcid":false,"given":"Francis","family":"Veyckemans","sequence":"additional","affiliation":[{"name":"UCLouvain Medical School  Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8041-1234","authenticated-orcid":false,"given":"Thomas","family":"Fuchs\u2010Buder","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Lorraine CHRU Nancy, H\u00f4pital de Brabois  Nancy France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1297-3427","authenticated-orcid":false,"given":"Thomas","family":"Riva","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8081-0684","authenticated-orcid":false,"given":"Markus","family":"Huber","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital University of Bern  Bern 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