Monitoring and reversal of neuromuscular block

Methods of monitoring and reversing neuromuscular blocking agents to avoid residual neuromuscular block are described. Studies have shown that if a long-acting neuromuscular blocking agent is used during anesthesia, the frequency of residual block, regardless of the method of neuromuscular monitorin...

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Bibliographic Details
Published in:American journal of health-system pharmacy 1999-06, Vol.56 (11), p.10-13
Main Author: BEVAN, D. R
Format: Article
Language:English
Subjects:
Anesthetics. Neuromuscular blocking agents
Biological and medical sciences
Drug Interactions
Drug Monitoring - methods
Humans
Medical sciences
Neuromuscular Agents - adverse effects
Neuromuscular Agents - antagonists & inhibitors
Neuromuscular Blocking Agents - adverse effects
Neuromuscular Blocking Agents - antagonists & inhibitors
Neuropharmacology
Parasympathomimetics - pharmacology
Pharmacology. Drug treatments
Postoperative Period
Time Factors
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Description
Summary:Methods of monitoring and reversing neuromuscular blocking agents to avoid residual neuromuscular block are described. Studies have shown that if a long-acting neuromuscular blocking agent is used during anesthesia, the frequency of residual block, regardless of the method of neuromuscular monitoring, will be at least 20%. In the past 20-25 years, anesthesiologists have come to use some form of nerve stimulation to monitor the degree of residual neuromuscular block; there are various patterns of stimulation, including train-of-four (TOF) stimulation and double-burst stimulation (DBS). For both TOF stimulation and DBS, the response to the stimuli in a series fades such that the last response can be expressed as a ratio of the first. The fade to DBS is the same as that to TOF stimulation. Clinicians can clinically detect a fade in TOF response when the TOF ratio is
ISSN:1079-2082
1535-2900
DOI:10.1093/ajhp/56.S10