PMID- 7595688
OWN - NLM
STAT- MEDLINE
DCOM- 19951228
LR  - 20191031
IS  - 0748-1977 (Print)
IS  - 0748-1977 (Linking)
VI  - 11
IP  - 5
DP  - 1995 Sep
TI  - Stabilization of the neuromuscular response when switching between different 
      modes of nerve stimulation at surgical degrees of neuromuscular blockade.
PG  - 317-23
AB  - During general anesthesia, different modes of nerve stimulation are used for 
      estimation of the degree of neuromuscular blockade. When switching between the 
      different modes, it is important to know whether the preceding mode influences 
      the responses to the succeeding mode, and if so, for how long. The object of our 
      study was to determine the number of stimulations required for stabilization of 
      the muscular response when switching between double-burst stimulation (DBS) 
      applied every 20 sec, train-of-four (TOF) applied every 12 sec, and posttetanic 
      count (PTC) at surgical degrees of neuromuscular blockade. A total of 33 women 
      were anesthetized with fentanyl, thiopental, halothane, and nitrous oxide. A 
      constant degree of neuromuscular blockade was maintained at a twitch height of 4 
      to 11% of the control twitch height using a continuous infusion of atracurium. 
      The ulnar nerve was stimulated supramaximally at the wrist, and the contraction 
      in the adductor pollicis was measured mechanomyographically. At surgical degrees 
      of neuromuscular blockade, only the first twitch response to TOF stimulation (T1) 
      and the first twitch response to DBS stimulation (D1) are consistently present. 
      When switching from DBS to TOF, 4 to 7 stimulations (56 to 92 sec) were required 
      for stabilization of the T1 response. When switching from TOF to DBS, 3 
      stimulations (36 to 52 sec) were required for stabilization of the D1 response, 
      and, finally, when switching from PTC to DBS, 5 to 11 stimulations (81 to 201 
      sec) were required for stabilization of the D1 response. Stabilization of D1 was 
      faster following TOF than following PTC (p < 0.01).(ABSTRACT TRUNCATED AT 250 
      WORDS)
FAU - Kirkegaard-Nielsen, H
AU  - Kirkegaard-Nielsen H
AD  - Department of Anaesthesia and Intensive Care, Odense University Hospital, 
      Denmark.
FAU - Helbo-Hansen, H S
AU  - Helbo-Hansen HS
FAU - Lindholm, P
AU  - Lindholm P
FAU - Krogh Severinsen, I
AU  - Krogh Severinsen I
FAU - Bulow, K
AU  - Bulow K
FAU - Jensen, E W
AU  - Jensen EW
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Clin Monit
JT  - Journal of clinical monitoring
JID - 8506707
RN  - 2GQ1IRY63P (Atracurium)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Atracurium/administration & dosage
MH  - Electric Stimulation/*methods
MH  - Female
MH  - Humans
MH  - Middle Aged
MH  - Monitoring, Intraoperative
MH  - *Nerve Block
MH  - Neuromuscular Junction/*physiology
MH  - Synaptic Transmission/physiology
EDAT- 1995/09/01 00:00
MHDA- 1995/09/01 00:01
CRDT- 1995/09/01 00:00
PHST- 1995/09/01 00:00 [pubmed]
PHST- 1995/09/01 00:01 [medline]
PHST- 1995/09/01 00:00 [entrez]
AID - 10.1007/BF01616990 [doi]
PST - ppublish
SO  - J Clin Monit. 1995 Sep;11(5):317-23. doi: 10.1007/BF01616990.