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July 1, 1986Anesthesia & Analgesia

Electrical and Mechanical Train-of-Four Responses during Depolarizing and Nondepolarizing Neuromuscular Blockade

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Why the study?

How do train-of-four responses measured by integrated electromyography compare to twitch force during depolarizing and nondepolarizing neuromuscular blockade?

Population

30 subjects undergoing nitrous oxide-fentanyl anesthesia

Comparison

Measurement of train-of-four responses by… vs Measurement of TOF responses by twitch force

Design

Other

Authors

SWStanley S. WeberUniversity of New MexicoSMStanley MuravchickBaptist Hospital of Miami

Discussion

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Implication

Alerts clinicians to IEMG-mechanical TOF discordance during recovery; leaves open whether IEMG should supplant mechanical monitoring.

Structured PICO

How do train-of-four responses measured by integrated electromyography compare to twitch force during depolarizing and nondepolarizing neuromuscular blockade?

P
Population
30 subjects undergoing nitrous oxide-fentanyl anesthesia
I
Intervention
Measurement of train-of-four (TOF) responses by integrated electromyography (IEMG) during neuromuscular blockade with atracurium, vecuronium, or succinylcholine
C
Comparator
Measurement of TOF responses by twitch force (mechanical)
O
Outcome
Simultaneous measurements of train-of-four (TOF) responses during neuromuscular blockade onset and recoverysurrogate

Integrated electromyography is a convenient and reliable method for monitoring nondepolarizing neuromuscular blockade, though mechanical TOF lags behind IEMG during recovery.

Cite This Study

Weber et al. (1986) studied this question.

synapsesocial.com/papers/6a901d7b0691efebbb2780d0https://doi.org/10.1213/00000539-198607000-00012
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Intraoperative Neuromuscular Monitoring: Electromyography Monitor Versus Peripheral Nerve Stimulator. Does the Face Lie?2026
  2. 2Does Perioperative Tactile Evaluation of the Train-of-four Response Influence the Frequency of Postoperative Residual Neuromuscular Blockade?1990 · 100 citations
  3. 3Train–of–four fade during onset of neuromuscular block with nondepolarising neuromuscular blocking agents1989 · 20 citations
  4. 4Assessment of Neuromuscular Blockade Using Acceleromyography Should Be Performed Before Emergence from Anesthesia2005 · 5 citations
  5. 5A comparison of train of four monitoring and double burst stimulation to assess residual neuromuscular blockade2023