A system comprising: at least one stimulating electrode; at least one recording electrode; a pulse generator for providing stimulation to a nerve through the stimulating electrode; and a computing device comprising a processor having instructions stored thereon, wherein when executed by the computing device cause the computing device to: apply stimuli to the nerve through the stimulating electrode according to a stimulation protocol, wherein the stimulation protocol provides a plurality of stimulation sequences that vary in frequency of pulses in the stimulation sequence, frequency of the stimulation sequences, number of pulses in the stimulation sequence, or all of the above; measure, by the recording electrode, electrical responses of a muscle; and estimate the degree of neuromuscular blockade by following a stimulation protocol of applying a first series of pulses as a first stimulation sequence and determining a first ratio between the electrical response of the muscle from a first pulse of said first series of pulses of said stimulation sequence and the electrical response of the muscle from a last pulse in said stimulation sequence; and automatically applying a second series of pulses as a second stimulation sequence if said first ratio is within a predetermined borderline range in which the neuromuscular blockage is not clear; said second series of pulses having either higher stimulation frequencies or a greater number of stimuli than said first series of pulses. at least one stimulating electrode; at least one recording electrode; a pulse generator for providing stimulation to a nerve through the stimulating electrode; and a computing device comprising a processor having instructions stored thereon, wherein when executed by the computing device cause the computing device to: apply stimuli to the nerve through the stimulating electrode according to a stimulation protocol, wherein the stimulation protocol provides a plurality of stimulation sequences that vary in frequency of pulses in the stimulation sequence, frequency of the stimulation sequences, number of pulses in the stimulation sequence, or all of the above; measure, by the recording electrode, electrical responses of a muscle; and estimate the degree of neuromuscular blockade by following a stimulation protocol of applying a first series of pulses as a first stimulation sequence and determining a first ratio between the electrical response of the muscle from a first pulse of said first series of pulses of said stimulation sequence and the electrical response of the muscle from a last pulse in said stimulation sequence; and automatically applying a second series of pulses as a second stimulation sequence if said first ratio is within a predetermined borderline range in which the neuromuscular blockage is not clear; said second series of pulses having either higher stimulation frequencies or a greater number of stimuli than said first series of pulses. apply stimuli to the nerve through the stimulating electrode according to a stimulation protocol, wherein the stimulation protocol provides a plurality of stimulation sequences that vary in frequency of pulses in the stimulation sequence, frequency of the stimulation sequences, number of pulses in the stimulation sequence, or all of the above; measure, by the recording electrode, electrical responses of a muscle; and estimate the degree of neuromuscular blockade by following a stimulation protocol of applying a first series of pulses as a first stimulation sequence and determining a first ratio between the electrical response of the muscle from a first pulse of said first series of pulses of said stimulation sequence and the electrical response of the muscle from a last pulse in said stimulation sequence; and automatically applying a second series of pulses as a second stimulation sequence if said first ratio is within a predetermined borderline range in which the neuromuscular blockage is not clear; said second series of pulses having either higher stimulation frequencies or a greater number of stimuli than said first series of pulses.