Measurement of neuromuscular blockade in man

Armstrong, Janet E.; Goat, V. A.; Loach, A. B.

doi:10.1111/j.1365-2044.1977.tb09987.x

Cited by 8 publications

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“…Ethical consent for this study was obtained and the trial was conducted with the authority of a clinical trial certificate issued by the Committee on the Safety of Drugs. After premedication with papaveretum and hyoscine, a modified Elcomatic transducer (Armstrong, Goat and Loach, 1977) was attached to the patient's dominant hand and positioned to achieve maximal mechanical response to thumb adduction. Anaesthesia was induced with fentanyl 3ngkg~' and thiopentone 5 mg kg" 1 , and maintained with nitrous oxide and oxygen; ventilation of the lungs was assisted via a face-mask.…”

Section: Methodsmentioning

confidence: 99%

Atracurium: Its Speed of Onset. A Comparison With Suxamethonium

Scott¹,

Goat²

1982

British Journal of Anaesthesia

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Forty healthy patients were randomly selected to receive either atracurium 0 6 mg kg ', or summethonium 1 mg kg"'. Onset of neuromuscular blockade and the time to full penpheral paralysis were measured using a train-of-four stimulus repeated once every 12 s. Atracunum appeared to be a potent non-depolanzmg muscle relaxant, with a rapid onset of action. However, full peripheral paralysis took longer to achieve than with suzamethonium. There were no significant problems with recovery.

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Section: Methodsmentioning

confidence: 99%

Atracurium: Its Speed of Onset. A Comparison With Suxamethonium

Scott¹,

Goat²

1982

British Journal of Anaesthesia

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A simple device for monitoring neuromuscular blockade in children

1989

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Apparatus and simple method of monitoring neuromuscular function

Chuang

TOUNG

2011

Acta Anaesthesiologica Taiwanica

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The use of muscle relaxant is an integral part of anesthetic management in present-day practice. Clinically, the neuromuscular blockade is evaluated by determining the thumb twitching to train-of-four (TOF) ulnar nerve stimulation at elbow.(1-3) There are many ways for the assessment of twitch response, such as the use of electromyography(4,5); force displacement transducer techniques(2,6-9); and most recently, the acceleration transducer-based system of neuromuscular monitoring.(10-15) These equipments are, however, bulky, cumbersome, expensive, or time consuming for operation. Because of these limitations, the routine use of such monitors is impractical. The evaluation of neuromuscular blockade, at the present time, relies on either visual or manual (tactile) thumb twitch responses to the TOF nerve stimulation. Visual or tactile evaluation of neuromuscular blockade is subjective and involves uncertainty, especially in the recovery phase. Furthermore, in certain surgical procedures, such as those on the head and neck, both hands are tucked in the sides of the table and become inaccessible, rendering visual or tactile evaluation of the thumb twitch impossible. In such situation, muscle relaxant is often given in the light of guessing rather than on objective basis. Clearly, there is a need for a simple and practical way of measuring the twitch responses to TOF stimulation during anesthesia. Based on the current method of stimulation of the ulnar nerve over the ulnar groove at the elbow, which elicits a string thumb adduction (because of stimulation of the flexor carpi ulnaris muscle), a simple method that can objectively monitor and record the thumb twitch is developed. The unique features of the method or device are its simplicity and its ability to adapt to any pressure transducer to display the twitch response to TOF simultaneously with electrocardiogram, arterial, or central venous pressure.

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Measurement of neuromuscular blockade in man

Cited by 8 publications

References 3 publications

Atracurium: Its Speed of Onset. A Comparison With Suxamethonium

Atracurium: Its Speed of Onset. A Comparison With Suxamethonium

A simple device for monitoring neuromuscular blockade in children

Apparatus and simple method of monitoring neuromuscular function

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