Post-tetanic burst count: A stimulating pattern for profound neuromuscular blockade
- 1 December 1995
- journal article
- research article
- Published by Springer Nature in Canadian Journal of Anesthesia/Journal canadien d'anesthésie
- Vol. 42 (12), 1096-1100
- https://doi.org/10.1007/bf03015095
Abstract
The purpose of this study was to compare the pattern of recovery from vecuronium 0.07 mg · kg−1 induced neuromuscular blockade using post-tetanic burst count (PTBC)-(three short tetanic bursts of 0.2 msec duration every 20 msec given every second following a tetanus), and post-tetanic count (PTC)-(0.2 msec single twitch stimuli given every second following a tetanus) using an accelerometer in 60 adult patients during nitrous oxide-oxygen-isoflurane anaesthesia. In addition, the relationship among PTBC, PTC, and T-1 (the 1st response in the train-of-four (TOF) stimulation) was examined to investigate whether the PTBC had an advantage over the PTC or TOF for evaluating intense neuromuscular blockade. The PTBC was greater than PTC during the 15–35 min after the administration of vecuronium (unpaired t test with Bonferroni’s correction, P < 0.05). Time to the return of PTB response was shorter than that of PTT (17.7 ± 3.2 vs 22.7 ± 3.7 min, unpaired t test, P = 0.0005). Time from the return of PTB to that of T-1 was longer than the time from the return of PTC to that of T-1 (13.3 ± 2.6 vs 9.2 ± 2.8 min, unpaired t test, P = 0.0003). At the return of T-1, PTBC was greater than PTC (14.3 ± 6.9 vs 9.4 ± 2.3, unpaired t test, P = 0.0153). These results suggest that, using PTBC, a more profound level of neuromuscular blockade can be evaluated than that using PTC. Cette étude visait à comparer, après curarisation au vécuronium 0,7 mg · kg−1 le pattern de la décurarisation avec le compte du burst post-tétanique (PTBC-trois courtes salves de tétanos de 0,2 sec aux 20 msec à toutes les secondes après un tétanos) avec celui du compte post-tétanique (PTC-un twitch simple de 0,2 msec à toutes les secondes après un tétanos). L’accélérométrie a été utilisé chez 60 patients adultes pendant une anesthésie à l’association N2O-oxygène-isoflurane. En outre, la relation entre PTBC, PTC et T1 (la première résponse du TOF) a été étudiée pour savoir si le PTBC avait un avantage sur le PTC ou le TOF pour évaluer la curarisation profonde. La PTBC a été supérieur au PTC et au TOF pendant les 15 à 35 min qui ont suivi l’administration de vécuronium (test T non pairé avec correction de Bonferroni, P < 0,05). L’intervalle précédant le retour du PTB a été plus court que celui du PTT (17,7 ± 3,2 vs 22,7 ± 3,7 min, test T non apparié, P = 0,0005). L’intervalle précédant le retour du PTB à celui du T1 a été plus long que celui du retour du PTC à celui du T1 (13,3 ± 2,6 vs 9,2 ± 2,8 min, test T non apparié, P = 0,0003). Au retour du T1 le PTBC a été plus grand que le PTC (14,3 ± 6,9 vs 9,4 ± 2,3 T non apparié, P = 0,0153). Ces résultats suggèrent que, avec le PTBC, un niveau plus profond de curarisation peut être évalué qu’avec le PTC.Keywords
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