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Relationship between Single Twitch Depression and Train-of-Four Fade

Influence of Relaxant Dose during Onset and Spontaneous Offset of Neuromuscular Blockade

Received from the Department of Anaesthetics, The United Medical and Dental Schools, Guy's Hospital, London, England. Address correspondence to Dr. Jones, Department of Anaesthetics, The United Medical and Dental Schools, Guy's Hospital, London SE1 9RT, UK.

Abstract

The characteristics of the train-of-four (TOF) response were studied electromyographically during onset and spontaneous offset of neuromuscular blockade with bolus doses of vecuronium (ED₉₅, and ED₉₅ x 2). During onset of blockade there was less fade with the larger than the smaller dose of vecuronium, demonstrating a variable and dose-related relationship between the ratio of height of the initial twitch, T1, and fourth twitch, T4, With both doses TOF fade was more pronounced during recovery than during onset of block, but at the same T1 values during offset, both doses were associated with similar degrees of fade during recovery. Thus with bolus doses of vecuronium the T4 ratio during recovery bears a fixed relationship to initial T1 depression that is independent of dose.

Key Words: NEUROMUSCULAR RELAXANTS—vecuronium. • MONITORING—electromyography, train-of-four.

This article has been cited by other articles:

				H. Itoh, K. Shibata, S. Nitta, and T. Kobayashi Train-of-four fade and neuromuscular block in rats: a comparison between pancuronium, vecuronium, and rocuronium Can J Anesth, October 1, 2000; 47(10): 950 - 955. [Abstract] [PDF]

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999