Submitted by Jeffrey Lake on Sun, 01/22/2017 - 6:34pm Are you an anesthesia provider in the United States? * Yes No Which of the following best describes your practice position? * anesthesiologist certified registered nurse anesthetist (CRNA) anesthesiologist assistant (AA) physician assistant (PA) Other, please specify Which of the following best describes your practice position? Other, please specify How many years have you been in practice? * <5 years 5 to <10 years 10 to <20 years 20 to <30 years 30 years or more Which of the following best describes your current practice setting? Community hospital University medical center with clinical practice University medical center without clinical practice Government facility Not currently practicing Other, please specify Which of the following best describes your current practice setting? Other, please specify How frequently do you currently use neuromuscular blockade monitoring for your patients in whom you have administered a neuromuscular blocking agent? * <25% of the time 25% - 50% of the time 50% - 75% of the time 75% - 99% of the time I always use neuromuscular blockade monitoring I never use neuromuscular blockade monitoring Comments: Please identify the type of monitoring you currently use in your practice: * Qualitative peripheral twitch count nerve stimulator Objective quantifiable nerve stimulator I do not use a nerve stimulator Please indicate manufacturer if known: Please indicate type: Accelerometry (eg, TOF Watch, Stimpod) Kinemyography (eg, GE Mechanosensor) Electromyography (eg, GE Electrosensor) Other Comments: What level of block do you most commonly maintain for laparoscopic surgery procedures? * Deep block (TOF 0/4) Moderate (TOF 1-2/4) Shallow (TOF 3-4/4) Please list procedures (cases) in which you consider deep neuromuscular block (TOF count 0/4 with post-tetanic count 1-2): Do you have Bridion (sugammadex) on formulary? * Yes No Do you have Bridion (sugammadex) readily available in the OR? * Yes No Are any restrictions placed on your use of Bridion (sugammadex)? Please describe: Have you ever personally used Bridion (sugammadex)? * Yes No If you are interested in participating in the raffle for a $100/€100 Amazon gift card, please fill out the following: First Name: Last Name: Email: Leave this field blank
