Awake Total Neuromuscular Blockade as Experienced by Anesthesiologist Volunteers

Research Letter| February 2024 Awake Total Neuromuscular Blockade as Experienced by Anesthesiologist Volunteers Peter J. Schuller, B.Sc., M.B.B.S., F.A.N.Z.C.A.; Peter J. Schuller, B.Sc., M.B.B.S., F.A.N.Z.C.A. 1Cairns Hospital, Cairns; James Cook University, Townsville, Queensland, Australia (P.J.S.). peterjschuller@gmail.com Search for other works by this author on: This Site PubMed Google Scholar Logan J. Voss, Ph.D.; Logan J. Voss, Ph.D. Search for other works by this author on: This Site PubMed Google Scholar John J. Barry, M.B.B.Ch. F.A.N.Z.C.A. John J. Barry, M.B.B.Ch. F.A.N.Z.C.A. Search for other works by this author on: This Site PubMed Google Scholar Author and Article Information (Accepted for publication October 11, 2023.) Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are available in both the HTML and PDF versions of this article. Links to the digital files are provided in the HTML text of this article on the Journal’s Web site (). Part of the work presented in this article was presented at the 10th International Memory and Awareness in Anaesthesia conference in Helsinki (poster) in June 19 to 21, 2017. Anesthesiology February 2024, Vol. 140, 336–338. https://doi.org/10.1097/ALN.0000000000004808 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn Email Cite Icon Cite Get Permissions Search Site Citation Peter J. Schuller, Logan J. Voss, John J. Barry; Awake Total Neuromuscular Blockade as Experienced by Anesthesiologist Volunteers. Anesthesiology 2024; 140:336–338 doi: https://doi.org/10.1097/ALN.0000000000004808 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll PublicationsAnesthesiology Search Advanced Search Topics: induction of neuromuscular blockade, neuromuscular blockade monitoring, paralysis Accidental awareness during general anesthesia can be profoundly traumatizing, even in the absence of pain.1,2 Neuromuscular blocking drugs are implicated in almost all cases of accidental awareness, yet despite having been in clinical use for more than 70 years, the subjective experience of awake neuromuscular blockade has been underinvestigated. We administered suxamethonium and rocuronium, on separate occasions, to 11 fully awake anesthesiologist volunteers in a previously published study of the Bispectral Index.3 We maintained communication during paralysis using the isolated-forearm technique and recorded the volunteers’ personal accounts the next day (tables 1 and 2). The study methods are included as Supplemental Digital Content (https://links.lww.com/ALN/D353).3 The sensation of paralysis between the two agents was markedly different, quite apart from the painful fasciculations from suxamethonium. Suxamethonium paralysis felt like a profound heaviness throughout the body as if “a giant hand was pressing me... You do not currently have access to this content.