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Current use of neuromuscular blocking agents and antagonists in Korea: a 2018 survey
Anesth Pain Med 2019;14(4):441-8
Published online October 31, 2019
© 2019 Korean Society of Neuroscience in Anesthesiology and Critical Care.

Jin Sun Kim1 , Jung Woo Han1 , Jae Ho Lee1 , Jae Moon Choi2 , Ha Jung Kim2 , Tae-Yun Sung3 , Yong Beom Kim4 , Yong Seop Shin5 , and Hong Seuk Yang6
Department of Anesthesiology and Pain Medicine, 1Gangneung Asan Medical Center, University of Ulsan College of Medicine, Gangneung, 2Asan Medical Center, University of Ulsan College of Medicine, Seoul, 3Konyang University Hopsital, Konyang University College of Medicine, Daejeon, 4Gil Medical Center, Gachon University College of Medicine, Incheon, 5Chungnam National University Hospital, Chungnam National University College of Medicine, 6Daejeon Sun General Hospital, Daejeon, Korea
Correspondence to: Hong Seuk Yang, M.D., Ph.D. Department of Anesthesiology and Pain Medicine, Daejeon Sun General Hospital, 29 Mokjung-ro, Jung-gu, Daejeon 34811, Korea Tel: 82-42-220-8921 Fax: 82-42-220-8933 E-mail:
Received November 19, 2018; Revised May 14, 2019; Accepted May 14, 2019.
cc This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: Neuromuscular blocking agents (NMBAs) and neuromuscular monitoring in anesthetic management are integral for endotracheal intubation, better visualization of the surgical field, and prevention of residual neuromuscular blockade and pulmonary complications. Sugammadex is a drug that reduces risk of residual neuromuscular blockade, with more rapid recovery compared to anticholinesterase. The purpose of this study was to investigate current usage status of NMBAs and antagonist with neuromuscular monitoring, among anesthesiologists in Korea.
Methods: Anesthesiologists working in Korea were invited to participate in an online survey via email January 2–February 28, 2018. The questionnaire consisted of 45 items, including preferred NMBAs, antagonists, neuromuscular monitoring, and complications related to the use sugammadex. A total of 174 responses were analyzed.
Results: Rocuronium was a commonly used NMBA for endotracheal intubation (98%) of hospitals, and maintenance of anesthesia (83.3%) in of hospitals. Sugammadex, pyridostigmine, and neostigmine were used in 89.1%, 87.9%, and 45.4% of hospitals. Neuromuscular monitoring was employed in 79.3% of hospitals; however only 39.7% of hospitals used neuromuscular monitoring before antagonist administration. Usual dosage range of sugammadex was 2.1–4 mg/kg in 35.1% of hospitals, within 2 mg/kg in 34.5% of hospitals, and 1 vial regardless of body weight in 22.4% of hospitals. Sugammadexrelated complications were encountered by 14.9% of respondents.
Conclusions: This survey indicates several minor problems associated with the use of antagonists and neuromuscular monitoring. However, most anesthesiologists appear to have appropriate information regarding the usage of NMBAs and sugammadex.
Key Words : Neostigmine; Neuromuscular blocking agents; Neuromuscular monitoring; Pyridostigmine bromide; Sugammadex.

October 2019, 14 (4)