Post-tetanic burst: a new monitoring method for intense neuromuscular block.
A new stimulation pattern for evaluation of intense neuromuscular block (post-tetanic burst (PTB)) was compared with post-tetanic twitch (PTT) during spontaneous recovery from vecuronium-induced neuromuscular block. Thirty adult patients were allocated to two equal groups and we measured times from administration of vecuronium 0.1 mg kg-1 to return of PTB and PTT responses, and evoked responses to PTB and PTT stimuli. For PTB stimulation, a 50-Hz tetanus was applied at 50 mA for 5 s, and after a pause of 3 s, a 50-Hz burst stimulation was applied, consisting of three impulses at 50 mA. PTB stimuli were delivered every 5 min. Similarly, PTT consisted of a tetanus, a 3-s pause and one single twitch stimulation repeated every 5 min. Time to return of the PTB response was significantly shorter than that of PTT (mean 23.7 (SD 7.9) compared with 30.7 (7.0) min) (P = 0.0160), although evoked responses to PTB did not differ significantly from those of PTT throughout recovery from vecuronium-induced neuromuscular block. This study suggested that PTB was more sensitive in evaluating intense neuromuscular block than PTT.
Saitoh
Y
Y
Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Tokyo Medical and Dental University, Japan.
Toyooka
H
H
Amaha
K
K
D000328:Adult; D000368:Aged; D000762:Anesthesia Recovery Period; D004558:Electric Stimulation / Q000379:methods*; D005071:Evoked Potentials / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D009407:Nerve Block; D009469:Neuromuscular Junction / Q000187:drug effects / Q000502:physiology*; D013997:Time Factors; D014673:Vecuronium Bromide
D014673:Vecuronium Bromide