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- Behdad Jahromi and Nebojsa Nick Knezevic.
- From the Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, Illinois.
- A A Pract. 2020 Nov 1; 14 (13): e01334.
AbstractNeuromuscular blocking agents are used during general anesthesia to optimize intubating and surgical conditions. Determining the level of neuromuscular blockade and ensuring adequate reversal are crucial to prevent anesthesia-related postoperative residual weakness and its associated complications. We present a 33-year-old woman who underwent laparoscopic appendectomy. Facial nerve stimulation failed to elicit response to neurostimulation, but subsequent ulnar nerve stimulation showed train-of-four count of 4 without fade in the adductor pollicis muscle. It was later determined that the patient recently received botulinum toxin treatment. Facial nerve stimulation is not a reliable method for neuromuscular blockade monitoring.
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