skip to main content

Residual neuromuscular blockade — FRCA Final MCQ

Instant feedback + full explanation. One question, done properly.

EasyGeneral AnaesthesiaResidual neuromuscular blockadeFRCA Final

A 74-year-old woman remains weak in recovery after laparoscopic colectomy. Quantitative train-of-four ratio is 0.38 after rocuronium, temperature is 36.7°C, and she is breathing shallowly with upper-airway obstruction. Surgery is finished and there is no concern about surgical bleeding. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Give sugammadex titrated to the depth of block

A low train-of-four ratio after rocuronium indicates clinically important residual neuromuscular blockade. Sugammadex is appropriate for aminosteroid blockade and should be dosed according to the measured depth of block. Neostigmine is unreliable for deep block and may not restore safe airway tone promptly. Quantitative neuromuscular monitoring is central to recognising and treating residual paralysis.

Reference: Association of Anaesthetists monitoring standards; BNF