| Post-tetanic count at adductor pollicis is a better indicator of early diaphragmatic recovery than train-of-four count at corrugator supercilii. | |
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MedLine Citation:
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PMID: 17561516 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Because the intensity of neuromuscular block at the diaphragm (DIA) is indirectly assessed, the electromyographic measurements of the DIA (DIA(EMG)) from surface electrodes were related to information provided by visual estimation of neuromuscular transmission at the adductor pollicis (AP) and the corrugator supercilii (CSC) during recovery from vecuronium block. METHODS: Twelve adult patients were studied during balanced anaesthesia. After induction of anaesthesia and tracheal intubation without neuromuscular blocking agent, supramaximal stimulations were applied to phrenic, ulnar and facial nerves. During recovery from vecuronium 0.1 mg kg(-1) an independent observer blinded to DIA(EMG) counted visually detectable train-of-four (TOF) at CSC (TOF(CSC)) and post-tetanic AP (PTC(AP)) responses. Times to recovery of PTC(AP) = 1, <or=5, <10 and >10, and TOF(CSC) = 1-4 responses were related to DIA(EMG). Values are means (sd). RESULTS: Reappearance of the first response to PTC(AP) occurred significantly (P < 0.05) earlier and for a lower recovery of DIA(EMG) than that of TOF(CSC) [24 (8) min vs 33 (9) min, and 10 (10)% vs 25 (8)%, respectively]. With PTC(AP) <or= 5 response, DIA(EMG) recovery was 21 (11)%. Recovery of TOF(CSC) = 1 and 2 coincided with DIA(EMG) recovery of 25 (8)% and 47 (9)%, respectively. CONCLUSIONS: PTC(AP) may better reflect early recovery of vecuronium-induced DIA paralysis than TOF(CSC). The findings suggested that PTC(AP) <or= 5 warranted deep neuromuscular block of the DIA. |
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Authors:
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G Dhonneur; K Kirov; C Motamed; R Amathieu; W Kamoun; V Slavov; S-K Ndoko |
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Publication Detail:
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Type: Comparative Study; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't Date: 2007-06-07 |
Journal Detail:
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Title: British journal of anaesthesia Volume: 99 ISSN: 0007-0912 ISO Abbreviation: Br J Anaesth Publication Date: 2007 Sep |
Date Detail:
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Created Date: 2007-08-17 Completed Date: 2007-10-16 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0372541 Medline TA: Br J Anaesth Country: England |
Other Details:
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Languages: eng Pagination: 376-9 Citation Subset: IM |
Affiliation:
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Anaesthesia and Intensive Care Department, Jean Verdier University Hospital of Paris, 93143 Bondy Cedex, France. gilles.dhonneur@jvr.aphp.fr |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Anesthesia Recovery Period* Diaphragm / drug effects*, physiology Electric Stimulation / methods Electromyography / drug effects Facial Muscles / drug effects, physiology Female Humans Male Middle Aged Monitoring, Physiologic / methods Muscle, Skeletal / drug effects*, physiology Neuromuscular Blockade Neuromuscular Junction / drug effects Neuromuscular Nondepolarizing Agents / pharmacology* Postoperative Care / methods Single-Blind Method Vecuronium Bromide / pharmacology* |
| Chemical | |
Reg. No./Substance:
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0/Neuromuscular Nondepolarizing Agents; 50700-72-6/Vecuronium Bromide |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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