{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T22:10:32Z","timestamp":1790892632468,"version":"4.1.0"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T00:00:00Z","timestamp":1756857600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Residual neuromuscular blockade (RNMB), defined as a train-of-four ratio (TOFR) &lt;0.90, is a complication of neuromuscular blocking agents (NMBA). Data about RNMB in children are rare. This single-center observational trial evaluated the rate of neuromuscular monitoring (NMM), the incidence, and consequences of RNMB in pediatrics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Children over 1 month undergoing elective and urgent surgery during core work hours receiving NMBA were included in an 84-day observation period. When the anesthesiologist decided to extubate, a blinded investigator measured the TOFR by acceleromyography. Data on demographics, surgery, anesthesia, and outcome were recorded. Comparison of qualitative variables was done using the chi-square test. The Mann\u2013Whitney U test was used to compare quantitative variables between patients with or without TOFR &lt;0.90.\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.05 was considered significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Eighty-nine children were included in the analysis. Rate of quantitative and qualitative NMM was 65.2% and 5.6%, respectively. Incidence of RNMB was 10.1% with TOFRs between 0.78 and 0.89 in 8 children and a TOFR of 0.48 in one child. Median time from the last NMBA administration to the TOFR before extubation was significantly shorter in patients with a TOFR &lt;0.90 in comparison with a TOFR \u22650.90 (88 vs. 110 min). In the RNMB group, qualitative NMM was significantly more often used compared with the no RNMB group (22.2% vs. 3.8%). Adverse events were rare with no significant differences between the two groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>RNMB in children is a relevant hazard. Qualitative NMM is not reliable to exclude RNMB. Institutional training programs on neuromuscular management in children may be helpful to improve the rate of quantitative NMM.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/sja.sja_394_25","type":"journal-article","created":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T12:00:49Z","timestamp":1756900849000},"page":"566-572","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["Infantile postoperative residual curarization (IPORC) - A prospective observational study"],"prefix":"10.4103","volume":"19","author":[{"given":"Christoph","family":"Unterbuchner","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology, University Medical Centre Regensburg, Regensburg, Germany"},{"name":"Department of Anaesthesiology, Krankenhaus Barmherzige Br\u00fcder, M\u00fcnchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian","family":"K\u00f6gel","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, University Medical Centre Regensburg, Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Ehehalt","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, University Medical Centre Regensburg, Regensburg, Germany"},{"name":"Department of Anaesthesiology, Klinikum Schwabing, M\u00fcnchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Metterlein","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, University Medical Centre Regensburg, Regensburg, Germany"},{"name":"Department of Anaesthesiology, Klinikum Landshut, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,9,3]]},"reference":[{"key":"R1-20260421","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1097\/EJA.0000000000000608","article-title":"Muscle relaxation for tracheal intubation during paediatric anaesthesia: A meta-analysis and trial sequential analysis","volume":"34","author":"Julien-Marsollier","year":"2017","journal-title":"Eur J Anaesthesiol"},{"key":"R2-20260421","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1213\/ANE.0b013e3181da832d","article-title":"Residual neuromuscular block: Lessons unlearned. 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