Korean J Anesthesiol.  1990 Jun;23(3):430-434. 10.4097/kjae.1990.23.3.430.

Comparison of Train - of - four Fade during Spontaneous Recovery of Various Nondepolarizing Neuromuscular Blockades

• Han CS
• Hwang KH
• Park W
• Kim SY

• KMID: 2239408
• DOI: http://doi.org/10.4097/kjae.1990.23.3.430

Abstract

Train-of-four (TOF) fade is a characteristic of the nondepolarizing neuromuscular blocking agents, but the degree of TOF fade has been shown to vary for different nondeplarizing relaxants. In the present study we measured the degree of fade of four nondepolarizing muscle relaxantsatracurium, vecuronium, pancuronium, and d-tubocurarine-during spontaneous recovery of neuromuscular blockade. Forty ASA class 1 or 2 adult patients were studied. All patients were premedicated with glycopyrrolate 0.2 mg and nalbuphine 10 mg IM, 1 hour before induction. After induction with pentothal sodium 5-6 mg/kg IV, neuromuscular monitoring was carried out by stimulaton of the ulnar nerve at the wrist with supramaximal stimuli at a frequency of 2 Hz repeated every 20 seconds using an ABM (Anesthesia and Brain activity Monitor, Datex Co.). The electromyographic response of hypothenar muscles was recorded. Following stabilization of control twitch height, the nondepolarizing relaxant was injected as a bolus dose, and tracheal intubation was performed when the first twich height of the train (T(1)) was 5% of the control. Anesthesia was maintained with O2-N2O (50%) -enflurane. Patients were divided into four groups according to use of relaxant: atracurium 0.4 mg/kg (n=10: group A), vecuronium 0.08 mg/kg (n=10; group V), pancuronium 0.08 mg/kg (n=10; group T), and d-tubocurarine 0.4 mg/kg (n= 10: group T). T(4) ratios at T(1) of 25, 50 and 75% recovery of T(1) and recovery index in each group were measured. The results were as follows: 1) The T(4) ratio was decreased significantly in P and T groups, as compared to A and V group. There were no significant differences between P and T groups, and between A and V groups (except 25% recovery of T(1)). 2) The recovery index was 14.8+/-2.36 min in A group, 16.4+/-1.85 min in V group, 51.2+/-4.17 min in P group, and 93.4+/-7.31 min in T group.

Keyword

Train-of-four fade; Nondepolarizing neuromuscular blockade

MeSH Terms

Adult
Anesthesia
Atracurium
Brain
Glycopyrrolate
Humans
Intubation
Muscles
Nalbuphine
Neuromuscular Blockade
Neuromuscular Blocking Agents
Neuromuscular Monitoring
Pancuronium
Sensitivity Training Groups
Sodium
Thiopental
Tubocurarine
Ulnar Nerve
Vecuronium Bromide
Wrist
Atracurium
Glycopyrrolate
Nalbuphine
Neuromuscular Blocking Agents
Pancuronium
Sodium
Thiopental
Tubocurarine
Vecuronium Bromide