[Comparison of the double burst stimulus with the train-of-four stimuli in monitoring muscle relaxation during anesthesia].
OBJECTIVE
To compare double burst stimulus (DBS) and the train-of-four stimuli (TOF) for monitoring neuromuscular blockade during anesthesia in terms of muscle relaxation requirements, dose of anticholinesterase agents and the possibility of postanesthetic residual relaxation.


METHODS
Patients were randomly assigned to two groups according to type of monitoring (DBS group, n = 29; and TOF group, n = 28), and were given an adjusted infusion of vecuronium to obtain response to stimulation with both methods of monitoring. When the block was considered to be sufficiently reversed in the operating theater, the patients were transferred to the postanesthesia recovery unit (PARU), where the coefficient between the fourth and first responses to TOF (T4/T1r) was obtained by electromyography and the patients were given the dose of neostigmine needed to obtain a T4/T1r > 70%


RESULTS
Vecuronium was infused at a faster rate during anesthesia in the DBS group than in the TOF group (1.0 +/- 0.19 microgram.kg-1.min-1 and 0.8 +/- 0.24 microgram. kg-1.min-1, respectively, p = 0.005). T4/T1r was less than 70% upon arrival at the PARU in 10 DBS patients and in 2 TOF patients (p = 0.02). No differences were found in neostigmine doses given.


CONCLUSIONS
The use of DBS increased the vecuronium dose required during anesthesia and risk in those patients who arrived at the PARU with residual muscle block (T4/T1r < 70%).
González-Arévalo
A
A
Servicio de Anestesiología, Hospital Universitatie, Getafe, Madrid.
Pensado
A
A
Caro
M M
MM
Jiménez
J
J
Jouve
M J
MJ
D000762:Anesthesia Recovery Period; D005073:Evoked Potentials, Somatosensory; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D009407:Nerve Block; D009467:Neuromuscular Depolarizing Agents; D009469:Neuromuscular Junction / Q000187:drug effects* / Q000502:physiology; D011446:Prospective Studies; D014673:Vecuronium Bromide
D009467:Neuromuscular Depolarizing Agents; D014673:Vecuronium Bromide
Comparación del estímulo a doble ráfaga frente al tren de cuatro estímulos en la monitorización de la relajación muscular durante la anestesia.