Rudolph MI, et al. - Via this retrospective cohort study of data on file, researchers created a REsidual neuromuscular block prediction score (REPS) to predict postoperative residual neuromuscular block (rNMB) and compared the accuracy of the prediction score with train-of-four count (TOFC) measurement at the end of a surgical case. They identified 10 independent predictors for residual paralysis (hepatic failure, neurological disease, high-neostigmine dose, metastatic tumor, female sex, short time between neuromuscular blocking agent administration and extubation, aminosteroidal neuromuscular blocking agent, BMI more than 35, absence of nurse anesthetist, and having an experienced surgeon) and used them for developing the score. Outcomes suggest the utility of the REPS in identifying patients at greater risk of rNMB. Compared to an intra-operative TOFC, this tool may better inform anesthetists and consequently allow peri-operative anesthetic practices to be customized to the patient and lessen the unwanted effects of rNMB.