Key Considerations for Preventing Residual Paralysis in the Perioperative Setting: What Managed Care Needs to Know About Neuromuscular Blockade Reversal

A continuing medical education activity sponsored by NAMCP and AAMCN.

This activity is an archive from the live webinar on May 8, 2019. If you participated in the live
session, you are not eligible for continuing education credits from this archive.

This activity is valid from May 20, 2019 to May 1, 2020

Instructions for CME/CNE: Complete the pre-test, listen to the audio and view the slides, complete the post test, complete the evaluation form and hit submit. You will be asked to enter your name and email address on the pre-test, evaluation and post-test. If you close your internet browser without completing the post test, you will have ONE more opportunity to complete. A score of 70% must be achieved on the post test to receive continuing education credits. If you do not pass the post test after two attempts, you will not be eligible to try again. Once you complete the evaluation form and score 70% or higher on your post test, you will automatically be given your certificate.

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Audience: This activity is intended for healthcare professionals practicing in managed care environments.

This presentation is supported by an educational grant from
Merck Sharp & Dohme Corp.

Neuromuscular blocking agents (NMBAs) are used in many surgical procedures and have enabled new surgical advances. The expanded landscape of NMB reversal drugs allows for fast and complete neuromuscular blockade (NMB) reversal and the reduction of postoperative complications from residual block. In the United States, neostigmine/ glycopyrrolate and sugammadex are the primary agents for pharmacologic antagonism of NMBAs. While neostigmine and an anticholinergic have been available for decades, sugammadex has only recently become available. This presentation will closely look at these options, determine what managed care needs to know about NMB and reversal, in a variety of surgeries and clinical settings in which the use of NMB reversal agents played a significant role in the patients' clinical outcome.

Upon completion of this activity, participants will be able to:

  • Define residual paralysis and complications related to residual paralysis in surgical patients

  • Explore current barriers to preventing residual paralysis in the perioperative setting

  • Compare and contrast newer options for neuromuscular blockade reversal for preventing residual paralysis with regard to efficacy, safety, and Pharmacoeconomics

  • Discuss managed care considerations of newer agents by exploring where these agents fit into the perioperative management paradigm

  • Analyze strategies used in monitoring and reversing anesthetic medications and preventing adverse drug events

Faculty: Deborah Wagner, PharmD, FASHP, Activity Chair
Clinical Pharmacist U-M Health System
Clinical Associate Professor of Pharmacy
College of Pharmacy
Clinical Associate Professor of Anesthesiology, Medical School
University of Michigan

S. Krishna Ramachandran, MD
Anesthesia, Critical Care, and Pain Medicine
Beth Israel Deaconess Medical Center and
Harvard Medical School


Dr. Wagner has served on an advisory board for Merck and is currently a consultant for Merck.
Dr. Ramachandran has served on an advisory board for Fresenius Kabi. He has received grant/research support from Merck in the past.
This presentation has been peer reviewed for any bias.
  Planning Committee:
Bill Williams, MD has no relevant financial relationships to disclose.
Jeremy Williams has no relevant financial relationships to disclose.
Will Williams has no relevant financial relationships to disclose.
Jacqueline Cole, RN, MS, CMCN has no relevant financial relationships to disclose.

NAMCP and/or the presenter has copyright or has received permissions for use of materials provided in this activity.

Accreditation & Designation
The National Association of Managed Care Physicians (NAMCP) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

NAMCP designates this enduring material for a maximum of 1 AMA PRA Category I creditsTM.

The American Association of Managed Care Nurses (AAMCN) is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation (ANCC).

Nurses who complete this activity and achieve a passing score will receive 1 hour in continuing
nursing credit.

This activity has been approved by the American Board of Managed Care Nursing for 1.0 contact hour toward CMCN recertification requirements.

This presentation is supported by an educational grant from
Merck Sharp & Dohme Corp.

NAMCP and/or this website does not provide medical advice, diagnosis or treatment. NAMCP does not endorse or imply endorsement of the content on any linked website. This website is to be used as an informational resource. With any health related concern, consult with your physician or healthcare professional.

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