Lwin Nyan S, Leslie Kate
Department of Critical Care, Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia.
Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Melbourne, Australia.
BJA Open. 2022 Aug 18;3:100028. doi: 10.1016/j.bjao.2022.100028. eCollection 2022 Sep.
The extent to which neuromuscular monitoring is included in professional anaesthesia society guidelines is unclear. Our aim was to comprehensively review neuromuscular monitoring guidelines published by these societies.
National societies were identified using the World Federation of Societies of Anaesthesiologists' member list and further manual searches were undertaken to identify multinational societies and specialist medical colleges. A web search and secondary literature search were conducted to locate guidelines for monitoring during anaesthesia. The income of each nation or group of nations was determined using the World Bank classification.
Forty guidelines were identified. Of 38 nations or classifiable groups of nations, 25 (66%) were high-income nations and 13 (34%) were middle-income nations. Neuromuscular monitoring was mentioned in 36 (90%) of the 40 guidelines. Availability of neuromuscular monitoring was mentioned in 17 (47%) guidelines (mandated in eight [47%] and recommended in nine [53%]). Use of neuromuscular monitoring was mentioned in 26 (72%) guidelines (mandated in three [12%] and recommended in 23 [88%]). Quantitative neuromuscular monitoring was specified in nine (25%) of the guidelines, with the type of monitoring unspecified in the remaining 27 (75%) of the 36 guidelines. Quantitative monitoring was only mandated in one guideline, and this was only when monitoring equipment was available.
We identified a gap in the availability of professional anaesthesia society neuromuscular monitoring guidelines, particularly in middle- and low-income nations. Recommendations about availability, use and type of monitoring varied among guidelines. An effort to improve the availability and consistency of guidelines is required.
专业麻醉学会指南中纳入神经肌肉监测的程度尚不清楚。我们的目的是全面回顾这些学会发布的神经肌肉监测指南。
利用世界麻醉医师协会联合会的成员名单确定各国学会，并进一步进行人工检索以确定跨国学会和专业医学院。进行网络搜索和二次文献检索以查找麻醉期间监测的指南。使用世界银行分类确定每个国家或国家组的收入。
共确定了40份指南。在38个国家或可分类的国家组中，25个（66%）是高收入国家，13个（34%）是中等收入国家。40份指南中有36份（90%）提到了神经肌肉监测。17份（47%）指南提到了神经肌肉监测的可及性（8份[47%]规定必须进行，9份[53%]建议进行）。26份（72%）指南提到了神经肌肉监测的使用（3份[12%]规定必须使用，23份[88%]建议使用）。9份（25%）指南明确了定量神经肌肉监测，其余36份中的27份（75%）未明确监测类型。只有一份指南规定必须进行定量监测，且仅在有监测设备时才进行。
我们发现专业麻醉学会神经肌肉监测指南的可及性存在差距，特别是在中低收入国家。指南中关于可及性、使用和监测类型的建议各不相同。需要努力提高指南的可及性和一致性。
