alexa Post-tetanic count at adductor pollicis is a better indicator of early diaphragmatic recovery than train-of-four count at corrugator supercilii.


Journal of Anesthesia & Clinical Research

Author(s): Dhonneur G, Kirov K, Motamed C, Amathieu R, Kamoun W,

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Abstract BACKGROUND: Because the intensity of neuromuscular block at the diaphragm (DIA) is indirectly assessed, the electromyographic measurements of the DIA (DIA(EMG)) from surface electrodes were related to information provided by visual estimation of neuromuscular transmission at the adductor pollicis (AP) and the corrugator supercilii (CSC) during recovery from vecuronium block. METHODS: Twelve adult patients were studied during balanced anaesthesia. After induction of anaesthesia and tracheal intubation without neuromuscular blocking agent, supramaximal stimulations were applied to phrenic, ulnar and facial nerves. During recovery from vecuronium 0.1 mg kg(-1) an independent observer blinded to DIA(EMG) counted visually detectable train-of-four (TOF) at CSC (TOF(CSC)) and post-tetanic AP (PTC(AP)) responses. Times to recovery of PTC(AP) = 1, 10, and TOF(CSC) = 1-4 responses were related to DIA(EMG). Values are means (sd). RESULTS: Reappearance of the first response to PTC(AP) occurred significantly (P < 0.05) earlier and for a lower recovery of DIA(EMG) than that of TOF(CSC) [24 (8) min vs 33 (9) min, and 10 (10)\% vs 25 (8)\%, respectively]. With PTC(AP)
  • DOI: 10.1093/bja/aem124
  • This article was published in Br J Anaesth and referenced in Journal of Anesthesia & Clinical Research

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