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...

Tetanic stimulation influences subsequent neuromuscular responses. In addition, the tetanus-induced changes in neuromuscular responses differ according to the level of neuromuscular block at which tetanic stimulation is delivered. We studied the tetanus-induced effect on subsequent train-of-four (TOF) responses at various levels of vecuronium-induced neuromuscular block in 45 anaesthetized pati...

Gentamicin in concentrations of 0.05--0.2 mmol litre-1 blocked neuromuscular transmission in the toad sartorius nerve--muscle preparation by decreasing the release of transmitter. In concetnrations of 0.5--1 mmol litre-1 it decreased the amplitude of the miniature end-plate current by a curare-like action, without affecting the mean open channel lifetime.

There is now mounting evidence that even small degrees of postoperative residual neuromuscular block increases the incidence of adverse respiratory events in the Post Anaesthesia Care Unit and may increase longer-term morbidity as well. In the absence of quantitative neuromuscular monitoring, residual block is easily missed. A very strong case can be made for the routine administration of a non...

Muscle relaxation is a routine part of anesthesia and has important advantages. However, the lingering effects of muscle relaxants in the postoperative period have historically been associated with postoperative adverse events. Neuromuscular reversal, together with neuromuscular monitoring, is a recognized strategy to reduce the rate of postoperative residual relaxation but has only marginally ...

BACKGROUND Of the polymethylene bismethonium congeners (C5-C12 and C18), decamethonium (C10) is the most potent neuromuscular blocking agent. We tested the hypothesis that these congeners act as straight molecules and will not bend easily in spite of the flexible connecting chain between the methonium heads. For congeners higher than C10, we also hypothesized that the relative difficulty with w...

THE INTERACTION Of antibiotics and neuromuscular blocking agents has been well documented. Neomycin, a.-~ streptomycin, 3 kanamycin, 3 gentamicin, 4'~ bacitraein, G polymyxin B ~ and colymicin ~ have been shown to potentiate the neuromuscular blockade of d-tubocurarine. The combined action of the muscle relaxant and the antibiotic is often resistant to reversal by both calcium '2,~3,~4 and neos...

This study examined the role of acetylcholine for skeletal muscle blood flow during exercise by use of the competitive neuromuscular blocking agent cisatracurium in combination with the acetylcholine receptor blocker glycopyrrone. Nine healthy male subjects performed a 10-min bout of one-legged knee-extensor exercise (18 W) during control conditions and with cisatracurium blockade, as well as w...

BACKGROUND Postoperative recovery after live donor nephrectomy is largely determined by the consequences of postoperative pain and analgesia consumptions. The use of deep neuromuscular blockade has been shown to reduce postoperative pain scores after laparoscopic surgery. In this study, we will investigate whether deep neuromuscular blockade also improves the early quality of recovery after liv...

We investigated the differences between males and females in the reversal effect of neostigmine on neuromuscular blockade. Thirty male and 30 female patients undergoing elective general anesthesia were studied. Vecuronium was given in all patients anesthetized with nitrous oxide, oxygen, and sevoflurane. After the surgical procedure, when T1 (1st response in train-of-four (TOF))/control returne...