Neuromuscular monitoring by intensive care nurses: comparison of acceleromyography and tactile assessment.
نویسندگان
چکیده
We have compared tactile assessment of the train-of-four (TOF) count and TOF ratio by nursing staff, with measurements made by a new acceleromyographic monitor, the TOF-Watch. We assessed neuromuscular block in 30 sedated intensive care patients receiving a continuous infusion of atracurium. Five nurses made a tactile assessment of neuromuscular block in each patient within a 5-min period. Each assessment was paired with a blinded TOF-Watch measurement. The nurses were accurate in assessing twitch count in 55% of measurements and they tended to overestimate the degree of block using tactile assessment of TOF ratio.
منابع مشابه
Vecuronium infusion requirements in paediatric patients in intensive care units: the use of acceleromyography.
Neuromuscular blocking drugs in intensive care units (ICU) may cause complications, including prolonged neuromuscular block as a result of overdosage and post-ventilation muscle weakness. These may be increased by using inappropriately high infusion rates for infants, in whom published studies are scarce, and by failure to monitor neuromuscular block. There is little ICU experience of accelerom...
متن کاملDevelopment of an algorithm using clinical tests to avoid post-operative residual neuromuscular block
BACKGROUND Quantitative neuromuscular monitoring is the gold standard to detect postoperative residual curarization (PORC). Many anesthesiologists, however, use insensitive, qualitative neuromuscular monitoring or unreliable, clinical tests. Goal of this multicentre, prospective, double-blinded, assessor controlled study was to develop an algorithm of muscle function tests to identify PORC. M...
متن کاملThe Effect of Implementation of a Pain Monitoring Protocol on the Pain Intensity in the Intensive Care Unit Semiconscious Patients
Background: Neglecting the pain assessment in intensive care unit (ICU) patients with decreased level of consciousness (LOC) can lead to inappropriate pain management. Implementation of a pain management protocol may contribute to avoiding such negligence. Aim: This study aimed to determine the effect of using a pain monitoring protocol on the pain intensity of ICU patients with decreased LOC. ...
متن کاملIntraoperative acceleromyography monitoring reduces symptoms of muscle weakness and improves quality of recovery in the early postoperative period.
BACKGROUND The subjective experience of residual neuromuscular blockade after emergence from anesthesia has not been examined systematically during postanesthesia care unit (PACU) stays. The authors hypothesized that acceleromyography monitoring would diminish unpleasant symptoms of residual paresis during recovery from anesthesia by reducing the percentage of patients with train-of-four ratios...
متن کاملOverestimation of Bispectral Index in sedated intensive care unit patients revealed by administration of muscle relaxant.
BACKGROUND Electromyographic activity has previously been reported to elevate the Bispectral Index (BIS) in patients not receiving neuromuscular blockade while under sedation in the intensive care unit. This study aimed to investigate the magnitude of the decrease of BIS following administration of muscle relaxant in sedated intensive care unit patients. METHODS The authors prospectively inve...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- British journal of anaesthesia
دوره 80 3 شماره
صفحات -
تاریخ انتشار 1998