Anaesthetists’ knowledge and frequency of use of neuromuscular monitoring at the University of the Witwatersrand

Abstract

Background: The use of neuromuscular blocking agents (NMBA) during general anaesthesia (GA) can result in postoperative residual neuromuscular blockade (PRNMB). Studies have shown that PRNMB can be reduced with the use of neuromuscular monitors (NMM). Data from South Africa about the knowledge and use of NMM is scarce. Therefore, this study aimed to determine the knowledge and the frequency of use of NMM in the Department of Anaesthesia at the University of the Witwatersrand (Wits).
Methods: A prospective, contextual study design was employed using a self-administered online questionnaire developed by the researcher with the assistance of senior anaesthetists. The study population consisted of all anaesthetists working in the Department of Anaesthesia at Wits. A convenience sampling method was used and a completed returned online questionnaire implied consent. Adequate knowledge was defined as a score of 65.5%, as determined by the Angoff method.
Results: From a total of 208 anaesthetists, 126 completed the questionnaire. There was an inadequate level of knowledge of NMM among anaesthetists in the department. Sixty-four per cent (64%) of the participants achieved less than the score of 65.5% as set by the Angoff method. The participants’ mean score for the questionnaire was 57%. The level of knowledge differs significantly among participants, depending on professional designation, with a p-value < 0.009. Medical officers and second-year registrars scored significantly below the Angoff score with p-values of 0.0005 and 0.02, respectively. First-year registrars recorded the highest score, followed by fourth-year registrars. The frequency of use of NMM in the department was low at 13%.
Conclusion: The level of knowledge among anaesthetists regarding NMM was inadequate. There is a need for the improvement of knowledge regarding NMM use, by ongoing education in the department. The use of NMM in the department was also low. The most common reason for not using NMM was the unavailability of these monitors.