A core element of anesthesia care is the use of intravenous muscle relaxants. While neuromuscular blockade (NMB) monitoring devices assess the degree of patient paralysis, few clinically convenient monitors exist. The lack of ergonomic NMB monitors results in inefficient dosing and patient morbidity. An analysis of challenges associated with NMB monitoring, as well as strengths and weaknesses of current noninvasive monitoring techniques, is presented as a foundation for the development of new NMB monitoring devices.