PMID- 26920705
OWN - NLM
STAT- MEDLINE
DCOM- 20170331
LR  - 20181202
IS  - 1496-8975 (Electronic)
IS  - 0832-610X (Linking)
VI  - 63
IP  - 7
DP  - 2016 Jul
TI  - Performing post-tetanic count during rocuronium blockade has limited impact on 
      subsequent twitch height or train-of-four responses.
PG  - 828-33
LID - 10.1007/s12630-016-0619-9 [doi]
AB  - BACKGROUND: Waiting five to six minutes before measuring a train-of-four (TOF) 
      after a 50-Hz tetanic stimulation or post-tetanic count (PTC) in order to allow 
      the facilitation of transmission to subside is commonly recommended but is based 
      on limited evidence. The purpose of this study was to measure the TOF responses 
      after PTC in one hand and to compare the responses with those in the 
      contralateral (control) hand. METHODS: Twenty-two adult patients undergoing 
      elective surgery under opioid-desflurane anesthesia were fitted with sensors to 
      measure displacement of their thumbs in response to ulnar nerve stimulation. 
      Rocuronium 0.6 mg.kg(-1) was administered and TOF stimulation was applied to both 
      sides. One side was randomized to PTC (50-Hz tetanus followed by a three-second 
      pause and 15 1-Hz stimuli) when the opposite (control) side recovered to 10% 
      first twitch (T1) height. Train-of-four stimulation was continued bilaterally 
      every 20 sec until 30 min after PTC. Comparisons of the T1 and TOF ratio (T4/T1) 
      were made at two, five, ten, 20, and 30 min. RESULTS: The mean (standard 
      deviation [SD]) T1 value in the PTC arm was 11.8 (7.1)% just before PTC. The T1 
      values were significantly greater in the PTC arm at two, five, and ten minutes, 
      with mean (SD) differences of 6.3 (6.7)%, 9.4 (6.8)%, and 7.4 (3.9)%, 
      respectively (P = 0.008). There were no significant differences in T1 values 
      between groups at 20 and 30 min, and no statistically significant differences in 
      T4/T1 values at any time. CONCLUSION: A small but clinically insignificant 
      increase in T1 is seen for at least ten minutes after PTC without any detectable 
      change in T4/T1 values. The TOF responses are reliable as early as one minute 
      after PTC.
FAU - Hakim, David
AU  - Hakim D
AD  - Department of Anesthesiology, Hopital Maisonneuve-Rosemont, 5415, boul. 
      l'Assomption, Montreal, QC, H1T 2M4, Canada.
FAU - Drolet, Pierre
AU  - Drolet P
AD  - Department of Anesthesiology, Hopital Maisonneuve-Rosemont, 5415, boul. 
      l'Assomption, Montreal, QC, H1T 2M4, Canada.
FAU - Donati, Francois
AU  - Donati F
AD  - Department of Anesthesiology, Hopital Maisonneuve-Rosemont, 5415, boul. 
      l'Assomption, Montreal, QC, H1T 2M4, Canada.
FAU - Fortier, Louis-Philippe
AU  - Fortier LP
AD  - Department of Anesthesiology, Hopital Maisonneuve-Rosemont, 5415, boul. 
      l'Assomption, Montreal, QC, H1T 2M4, Canada. fortierlp@mac.com.
AD  - Universite de Montreal, Montreal, QC, Canada. fortierlp@mac.com.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
TT  - La realisation d'un compte post-tetanique pendant un bloc au rocuronium a un 
      impact subsequent limite sur l'intensite de la contraction musculaire ou les 
      reponses au train-de-quatre.
DEP - 20160226
PL  - United States
TA  - Can J Anaesth
JT  - Canadian journal of anaesthesia = Journal canadien d'anesthesie
JID - 8701709
RN  - 0 (Androstanols)
RN  - 0 (Neuromuscular Nondepolarizing Agents)
RN  - WRE554RFEZ (Rocuronium)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Androstanols/*pharmacology
MH  - *Anesthesia Recovery Period
MH  - *Electric Stimulation
MH  - Female
MH  - Hand/innervation/physiopathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Neuromuscular Blockade/*methods
MH  - Neuromuscular Nondepolarizing Agents/*pharmacology
MH  - Rocuronium
MH  - Time Factors
MH  - Ulnar Nerve/*drug effects/physiopathology
MH  - Young Adult
EDAT- 2016/02/28 06:00
MHDA- 2017/04/01 06:00
CRDT- 2016/02/28 06:00
PHST- 2015/07/10 00:00 [received]
PHST- 2016/02/11 00:00 [accepted]
PHST- 2016/01/18 00:00 [revised]
PHST- 2016/02/28 06:00 [entrez]
PHST- 2016/02/28 06:00 [pubmed]
PHST- 2017/04/01 06:00 [medline]
AID - 10.1007/s12630-016-0619-9 [pii]
AID - 10.1007/s12630-016-0619-9 [doi]
PST - ppublish
SO  - Can J Anaesth. 2016 Jul;63(7):828-33. doi: 10.1007/s12630-016-0619-9. Epub 2016 
      Feb 26.