“With respect to monitoring, it must be that the combination of no monitoring or inconsistent monitoring and neostigmine reversal is associated with worse outcomes,” says researcher Matthias Eikermann, MD, PhD. “And it has been shown by our group that if you give neostigmine in the absence of neuromuscular block, it decreases muscle strength. So we speculate that this is the mechanism, and clinicians just use reversal in patients who don’t really need it.”
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