title: Visual evaluation of fade in response to facial nerve stimulation at the eyelid.
abstract: OBJECTIVE
  The aim of this study is to investigate the probability of visual detection of fade in response to train-of-four (TOF) stimulation, double-burst stimulation3,3 (DBS(3,3)), or DBS(3,2) at the eyelid in comparison to that at the thumb.
  
  
  METHODS
  This is a randomized single-blinded study.
  
  
  METHODS
  The study took place at the University hospital.
  
  
  METHODS
  Sixty adult patients underwent general anesthesia.
  
  
  METHODS
  Patients were randomly divided into either the eyelid group (n = 30) or the thumb group (n = 30). In the eyelid group, at the varying degrees of neuromuscular block caused by vecuronium, TOF, DBS(3,3), or DBS(3,2) were given at the temporal branch of the facial nerve, and the probability of visual detection of fade in response to TOF, DBS(3,3), or DBS(3,2) was determined at the eyelid. Similarly, in the thumb group, the probability of visual detection of fade in response to TOF, DBS(3,3), or DBS(3,2) was examined at the thumb.
  
  
  RESULTS
  When the true TOF ratios were 0 to 0.60, the probability of detection of TOF fade in the eyelid group was significantly lower than in the thumb group (P < .05). At the true TOF ratios of 0.31 to 0.70, the probability of visual detection of DBS(3,3) fade in the eyelid group was significantly less than in the thumb group (P < .05). When the true TOF ratios were 0.81 to 1.00, the probability of detection of DBS(3,2) fade in the eyelid group was significantly higher than in the thumb group (P < .05).
  
  
  CONCLUSIONS
  The probability of visual detection of fade in response to TOF or DBS(3,3) is lower at the eyelid than the thumb. In contrast, DBS(3,2) fade tends to be seen more frequently at the eyelid than at the thumb.
authors.affiliation: Department of Anesthesiology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan. hattori@sb.dcns.ne.jp
authors.forename: Hisashi
authors.initials: H
authors.lastname: Hattori
authors.forename: Yuhji
authors.initials: Y
authors.lastname: Saitoh
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nakajima
authors.forename: Norie
authors.initials: N
authors.lastname: Sanbe
authors.forename: Masahiko
authors.initials: M
authors.lastname: Akatu
authors.forename: Masahiro
authors.initials: M
authors.lastname: Murakawa
mesh_terms: D000328:Adult; D000368:Aged; D005143:Eyelids / Q000502:physiology*; D005154:Facial Nerve / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011336:Probability; D016037:Single-Blind Method; D013933:Thumb; D014459:Ulnar Nerve / Q000502:physiology; D014673:Vecuronium Bromide / Q000494:pharmacology
chemical_list: D014673:Vecuronium Bromide