The influence of the double burst stimulation (DBS) pattern on the DBS-train-of-four ratio relationship.
The double-burst-stimulation (DBS) is a new stimulation pattern developed to facilitate tactile evaluation of residual neuromuscular blockade. DBS consists of two bursts of high frequency stimulations separated by a short time interval.


METHODS
By changing these components, the influence of 14 different DBS patterns on the relationship between the DBS ratio and the train-of-four (TOF) ratio was investigated in 70 surgical and 10 intensive care patients during recovery from non-depolarising neuromuscular block.


RESULTS
Good linear correlations were observed between the different DBS- and TOF ratios with r2 values ranging from 0.90 to 0.97 (p < 10(-6). At a TOF ratio of 0.70 the DBS ratios ranged from 0.48 to 0.79 when changing between the 14 different DBS patterns. Change in number of pulses had the greatest influence on the slope of the regression line.


CONCLUSIONS
At any chosen level of reversal defined by a TOF ratio, it should therefore be possible to construct a DBS ratio, where fade just can be detected by tactile evaluation.
Kirkegaard-Nielsen
H
H
Department of Anesthesia, Esbjerg Central Hospital, Denmark.
May
O
O
D000762:Anesthesia Recovery Period; D001279:Atracurium / Q000008:administration & dosage; D003422:Critical Care; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004558:Electric Stimulation / Q000379:methods*; D004576:Electromyography / Q000187:drug effects; D006801:Humans; D009469:Neuromuscular Junction / Q000187:drug effects* / Q000502:physiology; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage*; D011930:Reaction Time / Q000187:drug effects
D003473:Neuromuscular Nondepolarizing Agents; D001279:Atracurium