European Journal of Anaesthesiology

Original Article
(RD) Surgery

Comparative use of muscle relaxants and their reversal in three European countries: a survey in France, Germany and Great Britain

C. Osmer a1c1, C. Vogele a1, B. Zickmann a1 and G. Hempelmann a1
a1 Department of Anaesthetics and Surgical Intensive Care, Justus-Liebig-University, Giessen, Department of Psychology, Philipps-University, Marburg, Germany

Article author query
osmer c   [PubMed][Google Scholar] 
vogele c   [PubMed][Google Scholar] 
zickmann b   [PubMed][Google Scholar] 
hempelmann g   [PubMed][Google Scholar] 


A survey was conducted among British, French and German anaesthetists to evaluate possible national differences in the peri-operative use of muscle relaxants and their reversal agents. The same non-depolarizing relaxants are used in all three countries, with the exception of d-tubocurarine, which is only available in Great Britain, and alcuronium which is mainly used in Germany. The French anaesthetists seem to use significantly less succinylcholine than their peers in Great Britain or Germany for both elective and emergency intubation. Monitoring of neuromuscular blockade still relies mainly on ‘clinical judgement’. Reversal of non-depolarizing muscle relaxants is performed routinely in Great Britain, while a substantial number of French anaesthetists avoid the use of a reversal. Dose regimes for neostigmine vary largely, with German anaesthetists administering the lowest, and British anaesthetists administering the highest doses. Side effects of reversal agents are reported by colleagues from all three countries in too high a percentage to justify uncritical administration of these drugs. In Germany there seems to be a noteworthy lack of recovery facilities.

(Published Online August 4 2006)
(Accepted January 1996)

Key Words: neuromuscular relaxants; neuromuscular blockade; cholinesterase-inhibitors; survey.

c1 Correspondence: Dr Christian Osmer, Abteilung für Anaesthesiologie und Operative Intensivmedizin, Justus-Liebig-Universität, Rudolf-Buchcheim-Str., D-35392 Giessen, Germany.