Multimodal imaging of an embolized vena cava filter strut causing right ventricular perforation

摘要

To the Editor, We read with interest the article by Dr. Donati on residual paralysis and the accompanying editorial. The author effectively, summarizes the rationale for documenting complete (near-complete) recovery from neuromuscular blockade and also points out that residual paralysis continues to occur frequently and likely increases perioperative complications. We don't necessarily view this as a deficiency of knowledge in the field but as a failure to implement what is known. It has been recognized for some time and published in major anesthesia texts that "normal respiratory and upper airway function does not return to normal unless the train of four ratio at the adductor pollicis is 0.9 or more" . As Dr. Donati points out, it is also understood that the twitch should be assessed at the adductor pollicis, not at the corrugator supercilii. This failure to implement "expert knowledge" is not unique to anesthesiologists.