Your child will undergo a non-urgent surgical procedure that does not involve the heart, or a relative emergency procedure scheduled more than 12 hours in advance.

The procedure will require the use of medications to temporarily relax muscles during surgery.

Your child will receive rocuronium, a medication that causes temporary muscle relaxation during the surgical procedure.

This medication will be given through an injection or infusion into a vein.

The dose will be determined by the medical team based on your child’s weight and the requirements of the surgery.

Additional doses may be given during the procedure if needed.

Throughout the procedure, the medical team will monitor the level of muscle relaxation using a device attached to your child’s thumb.

This monitoring uses a method called electromyographic monitoring, which measures the response of the thumb muscle to small electrical signals.

The measurements are recorded as TOFc (a count from 0 to 4) and TOFr (a percentage), which indicate how relaxed the muscles are.

When the surgical procedure is complete, your child will receive sugammadex, a medication that reverses the muscle relaxation caused by rocuronium.

The medication will be given through an injection into a vein.

Your child will receive an initial dose of 0.2 mg per kilogram of body weight.

The medical team will measure the muscle response approximately 3 minutes after each dose.

If the muscle function has not fully returned (meaning the TOFr is not yet above 90%), your child will receive an additional dose of 0.2 mg per kilogram.

This process will be repeated, with doses given approximately every 3 minutes, until complete muscle function is restored.

After each dose of sugammadex, the medical team will continue to monitor your child’s muscle function using the same device on the thumb.

The goal is to achieve complete reversal of muscle relaxation, defined as a TOFc of 4 out of 4 and a TOFr of 90% or higher.

The medical team will check for any signs of muscle relaxation returning unexpectedly during this process.

This would be identified by a decrease in the measurements taken from the thumb muscle.

After your child achieves complete muscle function recovery, monitoring will continue for up to 60 minutes.

During this time, the medical team will check to ensure that muscle relaxation does not return.

This is done by continuing to measure the muscle response at regular intervals.

The medical team will also observe your child for any breathing difficulties during the waking process or in the intensive care unit if applicable.

Throughout the entire process and after the procedure, the medical team will monitor your child for any adverse reactions related to the sugammadex medication.

This includes watching for any return of muscle relaxation, breathing problems, or allergic reactions to the medication.

Any such events will be recorded and managed appropriately by the medical team.