Korean J Anesthesiol.  2006 Mar;50(3):262-265. 10.4097/kjae.2006.50.3.262.

Video Imaging to Assess the Neuromuscular Effect at the Larynx

• Bang KS
• Do JY
• Kim IS
• Hong SJ
• Shin KM

• KMID: 1936724
• DOI: http://doi.org/10.4097/kjae.2006.50.3.262

Abstract

BACKGROUND: Rocuronium has been reported to develop a rapid onset of action and may be suitable as a component of a rapid-sequence intubation. The purpose of this study was to compare the onset of rocuronium at the adductor pollicis and the larynx and to determine the time suitable for intubation.
METHODS
Fifteen ASA physical status 1 and 2 adult patients were studied. Anesthesia was induced and maintained with propofol and alfentanil. The recurrent laryngeal nerve was stimulated superficially and movement of the vocal cords were recorded on video tape by using a fiberoptic bronchoscope passed via a laryngeal mask airway. Neuromuscular function was recorded at the adductor pollicis by using mechanosensor. After the administration of rocuronium 0.9 mg.kg(-1), the times to loss of fourth twitch response in train -of - four stimulation at the larynx and hand were observed.
RESULTS
The times to loss of fourth twitch response in train-of-four stimulation at the larynx and hand are 47.3 +/- 12.8 sec and 70 +/- 13.6 sec respectively.
CONCLUSIONS
Video imaging may be a useful research technique for estimating the neuromuscular blockade at the larynx and showing the onset time of rocuronium is significantly faster at the larynx than hand.

Keyword

intubation; neuromuscular effect; rocuronium

MeSH Terms

Adult
Alfentanil
Anesthesia
Bronchoscopes
Hand
Humans
Intubation
Laryngeal Masks
Larynx*
Neuromuscular Agents*
Neuromuscular Blockade
Propofol
Recurrent Laryngeal Nerve
Research Design
Vocal Cords
Alfentanil
Neuromuscular Agents
Propofol