Does perioperative tactile evaluation of the train-of-four response influence the frequency of postoperative residual neuromuscular blockade?
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Does perioperative tactile evaluation of the train-of-four response influence the frequency of postoperative residual neuromuscular blockade? / Pedersen, T; Viby-Mogensen, J; Bang, U; Olsen, Niels Vidiendal; Jensen, E; Engboek, J.
In: Anesthesiology, Vol. 73, No. 5, 11.1990, p. 835-9.Research output: Contribution to journal › Journal article › Research › peer-review
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T1 - Does perioperative tactile evaluation of the train-of-four response influence the frequency of postoperative residual neuromuscular blockade?
AU - Pedersen, T
AU - Viby-Mogensen, J
AU - Bang, U
AU - Olsen, Niels Vidiendal
AU - Jensen, E
AU - Engboek, J
PY - 1990/11
Y1 - 1990/11
N2 - The authors conducted a randomized controlled clinical trial to evaluate the usefulness of perioperative manual evaluation of the response to train-of-four (TOF) nerve stimulation. A total of 80 patients were divided into four groups of 20 each. For two groups (one given vecuronium and one pancuronium), the anesthetists assessed the degree of neuromuscular blockade during operation and during recovery from neuromuscular blockade by manual evaluation of the response to TOF nerve stimulation. In the other two groups, one of which received vecuronium and the other pancuronium, the anesthetists evaluated the degree of neuromuscular blockade solely by clinical criteria. The use of a nerve stimulator was found to have no effect on the dose of relaxant given during anesthesia, on the need for supplementary doses of anticholinesterase in the recovery room, on the time from end of surgery to end of anesthesia, or on the incidence of postoperative residual neuromuscular blockade evaluated clinically. The median (and range of) TOF ratios recorded in the recovery room were 0.75 (0.33-0.96) and 0.79 (0.10-0.97) in the vecuronium groups monitored with and without a nerve stimulator, respectively. These ratios were significantly higher than those found in the pancuronium groups, which wre 0.66 (0.06-0.90) and 0.63 (0.29-0.95), respectively. However, no difference was found between the vecuronium and pancuronium groups in the number of patients showing clinical signs of residual neuromuscular blockade, as evaluated by the 5-s head-lift test.(ABSTRACT TRUNCATED AT 250 WORDS)
AB - The authors conducted a randomized controlled clinical trial to evaluate the usefulness of perioperative manual evaluation of the response to train-of-four (TOF) nerve stimulation. A total of 80 patients were divided into four groups of 20 each. For two groups (one given vecuronium and one pancuronium), the anesthetists assessed the degree of neuromuscular blockade during operation and during recovery from neuromuscular blockade by manual evaluation of the response to TOF nerve stimulation. In the other two groups, one of which received vecuronium and the other pancuronium, the anesthetists evaluated the degree of neuromuscular blockade solely by clinical criteria. The use of a nerve stimulator was found to have no effect on the dose of relaxant given during anesthesia, on the need for supplementary doses of anticholinesterase in the recovery room, on the time from end of surgery to end of anesthesia, or on the incidence of postoperative residual neuromuscular blockade evaluated clinically. The median (and range of) TOF ratios recorded in the recovery room were 0.75 (0.33-0.96) and 0.79 (0.10-0.97) in the vecuronium groups monitored with and without a nerve stimulator, respectively. These ratios were significantly higher than those found in the pancuronium groups, which wre 0.66 (0.06-0.90) and 0.63 (0.29-0.95), respectively. However, no difference was found between the vecuronium and pancuronium groups in the number of patients showing clinical signs of residual neuromuscular blockade, as evaluated by the 5-s head-lift test.(ABSTRACT TRUNCATED AT 250 WORDS)
KW - Aged
KW - Electric Stimulation
KW - Female
KW - Humans
KW - Intraoperative Period
KW - Male
KW - Middle Aged
KW - Monitoring, Intraoperative
KW - Neuromuscular Blocking Agents
KW - Neuromuscular Junction
KW - Pancuronium
KW - Postoperative Period
KW - Touch
KW - Ulnar Nerve
KW - Vecuronium Bromide
M3 - Journal article
C2 - 1978613
VL - 73
SP - 835
EP - 839
JO - Anesthesiology
JF - Anesthesiology
SN - 0003-3022
IS - 5
ER -
ID: 47240971