1. RESIDUAL NEUROMUSCULAR BLOCKADE A Near Miss event In the post anesthesia care unit, a 58 years old, mild anemic, female, with no other known comorbids, after uneventfull esophagoscopy and dilatation under general anesthesia, Starts complaining of difficulty in breathing, tachypnoea and became cyanosed. Aspiration of secretions was suspected, and was re-intubated and ventilated In ICU for 36 hours.

2. RESIDUAL NEUROMUSCULAR BLOCK a common complication in the postanesthesia care unit approximately 40% of patients exhibiting a train of-four ratio 0.9. Glenn S. Murphy, Sorin J. Brull, Residual Neuromuscular Block: Lessons Unlearned.Part I: Definitions, Incidence, and Adverse Physiologic Effects of Residual Neuromuscular block. (Anesth Analg 2010;111:1208) 3. DEFINTION Residual neuromuscular blockade can be defined by Inadequate neuromuscular recovery as measured by objective neuromuscular monitoring. More specifically, recent opinion suggests a definition of inadequate train of four recovery of less than 0.9 (TOF