title: Is the diagnosis of significant residual neuromuscular blockade improved by using double-burst nerve stimulation?
abstract: This study evaluated the use of double-burst stimulation (DBS) in the diagnosis of significant post-operative residual neuromuscular blockade. Ninety patients were allocated to three equal groups. In Group A the degree of residual neuromuscular blockade was assessed by clinical criteria (CC) only; in Group B by CC and manual evaluation of the response to train-of-four (TOF) nerve stimulation; and in Group C by CC, manual evaluation of the response to TOF, and DBS stimulation. Immediately after arrival in the recovery room mechanical twitch was recorded using TOF stimulation. The mean (+/- SD) TOF ratios were 0.53 +/- 0.19 in Group A, 0.67 +/- 0.11 in Group B and 0.81 +/- 0.08 in Group C. The incidence of a TOF ratio of less than 0.7 was 83.3% in Group A, 56.7% in Group B and 6.7% in Group C. It is concluded that the use of DBS enabled the anaesthetist to recognize significant residual block and thus reduced the incidence of post-operative residual neuromuscular blockade.
authors.affiliation: Department of Anesthesiology, Kurume University, School of Medicine, Fukuoka, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Ueda
authors.forename: T
authors.initials: T
authors.lastname: Muteki
authors.forename: H
authors.initials: H
authors.lastname: Tsuda
authors.forename: S
authors.initials: S
authors.lastname: Inoue
authors.forename: H
authors.initials: H
authors.lastname: Nishina
mesh_terms: D000704:Analysis of Variance; D000769:Anesthesia, Inhalation; D000771:Anesthesia, Intravenous; D004558:Electric Stimulation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009126:Muscle Relaxation / Q000187:drug effects / Q000502:physiology; D009388:Neostigmine / Q000627:therapeutic use; D009469:Neuromuscular Junction / Q000187:drug effects / Q000502:physiology*; D010197:Pancuronium / Q000008:administration & dosage / Q000037:antagonists & inhibitors / Q000494:pharmacology*; D009435:Synaptic Transmission / Q000187:drug effects / Q000502:physiology*; D013997:Time Factors
chemical_list: D009388:Neostigmine; D010197:Pancuronium