Post-tetanic burst: a new monitoring method for intense neuromuscular block |
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Authors: | SAITOH, Y. TOYOOKA, H. AMAHA, K. |
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Affiliation: | Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Tokyo Medical and Dental University 5-45 Yushima, 1-chome, Bunkyo-ku, Tokyo 113, Japan |
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Abstract: | A new stimulation pattern for evaluation of intense neuromuscularblock (post-tetanic burst (PTB)) was compared with post-tetanictwitch (PTT) during spontaneous recovery from vecuronium-inducedneuromuscular block. Thirty adult patients were allocated totwo equal groups and we measured times from administration ofvecuronium 0.1 mg kg1 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 pauseof 3 s, a 50-Hz burst stimulation was applied, consisting ofthree impulses at 50 mA. PTB stimuli were delivered every 5min. Similarly, PTT consisted of a tetanus, a 3-s pause andone single twitch stimulation repeated every 5 min. Time toreturn of the PTB response was significantly shorter than thatof 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 significantlyfrom those of PTT throughout recovery from vecuronium-inducedneuromuscular block. This study suggested that PTB was moresensitive in evaluating intense neuromuscular block than PTT.(Br. J. Anaesth. 1995; 74: 293295) |
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