Supplementum 305: Abstracts SwissAnaesthesia 2026, joint annual congress of the Swiss Society for Anaesthesiology and Perioperative Medicine and the Swiss Association for Anaesthesia Care (Interlaken, Switzerland, November 5−7, 2026)

Background: Neuromuscular blocking agents (NMBA) are used to facilitate tracheal intubation in both adults and children.However, the paediatric population is highly heterogeneous with regard to age, resulting in relevant differences in physiological and pharmacological responses.Consequently, NMBA use, monitoring, and reversal may vary considerably in clinical practice.Although recent guidelines by the European Society of Anaesthesiology and Intensive Care (ESAIC) and the European Society of Paediatric Anaesthesia (ESPA) provide recommendations, real-world practice remains insufficiently characterised.We aimed to identify and characterize self-reported NMBA practice patterns across different European and non-European countries prior to publication of the ESAIC-ESPA guidelines.Methods: We performed an international, anonymous, crosssectional, web-based survey conducted between 12 November and 12 December 2025 consisting of 36 questions regarding the practice of NMBA.Results: The survey was accessed by 904 persons from 43 countries, and 874 responses were included in the analysis.Most participants were from Europe (83.5%) and worked in mixed paediatric anaesthesia and intensive care settings (71.2%).Rocuronium was the most used NMBA for routine tracheal intubation (68%, 95%CI 65-71) and for rapid sequence intubation (67%, 95%CI 64-70).NMBA were used "always" or "mostly" before routine intubation in 47% of neonates (≤ 30 days) and 50% of infants (<1 year), whereas "rarely" or "never" use was reported in 30% and 24%, respectively.Most respondents (56%) assessed adequate NMB using a fixed time interval after NMBA administration.NMBA reversal was administered "always" before extubation by 27% of respondents, while 9.3% and 2.9% reported "rarely" or "never".Only half of the participants used quantitative neuromuscular monitoring to guide reversal.Sugammadex was used by 47%.Conclusion: Self-reported NMBA practice in paediatric anaesthesia and intensive care shows substantial variability, particularly in neonates and infants.A considerable proportion of patients are intubated without NMBA and extubated without consistent reversal.Furthermore, quantitative neuromuscular monitoring remains underused.These findings underline the importance of implementation on a local level with the aim to improve paediatric care.