Reflections from the 2025 International Neuromuscular Symposium

Last week, I had the privilege of attending the 2025 International Neuromuscular Symposium—an inspiring and collaborative gathering of global thought leaders in anesthesia.

Held in Budapest, the meeting brought together renowned clinicians, researchers, and implementation experts from over a dozen countries—united by a shared goal: improving patient safety through quantitative neuromuscular monitoring. 

Several discussions focused on why quantitative neuromuscular monitoring adoption has been so slow. The reasons are multifactorial—outdated habits, inconsistent guidelines, limited training, and general resistance to change. Fortunately, the proposed solutions were equally clear.

Highlights included:

•    Mandating quantitative neuromuscular monitoring as a standard of care
•    Embedding validated Quality Indicators (QIs) into hospital frameworks
•    Prioritizing resident education and hands-on training

It was energizing to witness the collective momentum behind these ideas. The message resonated: we need champions at every level—international, national, and local—to make meaningful change.

One of the most exciting developments was the group’s commitment to developing an international consensus statement using the Delphi method. This statement will serve as a guiding framework for clinical implementation, education, and ongoing research. It marks a pivotal step toward global alignment on best practices in neuromuscular management.

With such widespread international alignment, we have an opportunity to translate global consensus into everyday clinical practice.

—Dr. Sorin Brull

1. Moving from evidence to everyday use– The evidence supporting quantitative neuromuscular monitoring is robust. Now, we must focus on adoption through cultural change and workflow integration. 
    
2. Validated QIs are essential – “If you can’t measure it, you can’t improve it.” Standardized, patient-centered QIs are urgently needed.
    
3. Young clinicians will lead the way – Mentorship and hands-on training for early-career professionals are vital to driving long-term adoption.
    
4. The time to act is now – With so much international momentum, we have a rare opportunity to turn consensus into clinical reality.