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Funding Residual paralysis with the use of non-depolarizing muscle relaxants is a problem that has beset us for many years.1 Much has been written about avoiding it and about the need to monitor relaxation at the completion of the surgery in order to avoid undesirable effects in the recovery room,2 and identify the need for reversal when required.3 There is a lot of debate about whether monitoring of intra-operative paralysis is necessary, but there is little discussion on whether it should be monitored at the end of the surgery, and still less about whether residual paralysis must be reverted post-operatively.4 At the end of the article on “Residual post-operative paralysis in patients over 65 in the Post-Anaesthetic Care Unit,”5 the authors ask whether it is necessary to revert residual paralysis. This is a matter about which there is little doubt in the current literature since it has been determined that a T4/T1 ratio of 0.90 has to be present before sending a patient to the post-anaesthetic care unit, and failure to ensure this is considered by some as an adverse event.6 In the study, although monitoring in some of the patients indicated the presence of

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