To analyze practice habits associated with the use, reversal and monitoring of nondepolarizing
neuromuscular blocking agents (NMBAs) in dogs by different groups of veterinarians.
Online anonymous survey to veterinarians.
Data from 390 answered surveys.
A questionnaire was sent to e-mail list servers of the American College of Veterinary
Anesthesia and Analgesia (ACVAA-list), Sociedad Española de Anestesia y Analgesia
Veterinaria (SEEAV-list), Colégio Brasileiro de Anestesiologia Veterinária (Brazilian
College of Veterinary Anesthesiology; CBAV-list) and American College of Veterinary
Ophthalmologists (ACVO-list) to elicit information regarding use of NMBAs and reversal
agents, monitoring techniques, criteria for redosing, reversing and assessing adequacy
of recovery of neuromuscular function. Binomial logistic regression was used to test
for association between responses and group of veterinarians in selected questions.
Veterinarians of the ACVO-list use NMBAs on a higher fraction of their caseload than
other groups (all p < 0.0001). Subjective assessment (observation) of spontaneous movement, including
spontaneous breathing, is the most common method for assessing neuromuscular function
(43% of pooled responses); 18% of participants always reverse NMBAs, whereas 16% never
reverse them. Restoration of neuromuscular function is assessed subjectively by 35%
of respondents. Residual neuromuscular block is the most common concern regarding
the use of NMBAs for all groups of veterinarians. Side effects of reversal agents
(anticholinesterases) were of least concern for all groups.
Conclusions and clinical relevance
While most veterinarians are concerned about residual neuromuscular block, relatively
few steps are implemented to reduce the risks of this complication, such as routine
use of quantitative neuromuscular monitoring or routine reversal of NMBAs. These results
suggest a limitation in transferring information among groups of veterinarians, or
in implementing techniques suggested by scientific research.