Muscle relaxants may also be given intraoperatively to improve surgical access such as relaxing abdominal muscles during bowl surgery. The level of neuromuscular blockade is monitored using a neuromuscular stimulator, and observing the degree and strength of muscles, generally those of the hand, to electrical stimulation. Additional, a muscle relaxant reversal agent at the end of the procedure.
Despite anecdotal stories, it is extremely rare for patients to have any intraoperative awareness of their surgery, muscle blockade, etc., as anesthesia is induced and maintained using a combination of drugs including those specifically chosen for their amnesic and pain relieving properties. Although still quite rare, most case reports of intraoperative awareness occur either during emergency caesarean sections under general anesthesia, where the Anesthesiologist is trying to limit the amount of anesthetic agent received by the baby prior to delivery, or during emergency trauma surgery, where the Anesthesiologist must balance inducing anesthesia and amnesia with the effects of anesthetic agents on blood pressure in patients with severe trauma and blood loss.