ReviewPaediatric anaesthesia2026
Error Traps in Pediatric Neuromuscular Block.
Review in Paediatric anaesthesia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
0 citing papers in PubMed.
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Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNeuromuscular blocking agents are essential for safe pediatric anesthesia but remain a frequent source of preventable morbidity when misused, inadequately monitored, or incompletely reversed. Children, particularly neonates and infants, are especially vulnerable to residual neuromuscular block due to developmental pharmacological variability and limited physiological reserve.
aimsTo describe common and preventable "error traps" in pediatric neuromuscular block management and to highlight strategies to improve safety across the perioperative continuum.
methodsThis narrative review synthesizes current evidence and clinical practice patterns to identify recurrent pitfalls in the use, monitoring, reversal, and postoperative management of neuromuscular blocking agents in children.
resultsFour major error traps were identified: omission of neuromuscular blocking agents when optimal intubating conditions are required; failure to use quantitative neuromuscular monitoring; inappropriate or mistimed pharmacological reversal; and failure to recognize and treat residual paralysis. These errors contribute to a persistently high incidence of residual neuromuscular block and are associated with increased risk of postoperative respiratory complications. Developmental pharmacokinetic and pharmacodynamic variability further amplifies these risks in pediatric populations.
conclusionsAvoidance of these error traps requires systematic application of evidence-based practices, including routine use of quantitative neuromuscular monitoring and objective confirmation of recovery with a train-of-four ratio ≥ 0.9 prior to extubation. Embedding these principles into clinical practice is essential to improving safety in pediatric anesthesia.
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