Differences of Onset of Different Muscles in Man and Their Consequences on Monitoring of Neuromuscular Transmission
The main goals of muscular relaxation during induction of anaesthesia are the paralysis of the vocal cords and jaw muscles to facilitate tracheal intubation and the relaxation of the respiratory muscles. Stimulation of the ulnar nerve in association with monitoring of the adductor pollicis has been used for many years to determine the onset and intensity of neuromuscular block. However it has been demonstrated that time course of neuromuscular block in various skeletal muscles is different from that in the adductor pollicis and discrepancies could exist both in onset time and intensity of paralysis. Therefore new sites of stimulation have been introduced recently in order to assess the onset and intensity of neuromuscular block at different muscles.
KeywordsVocal Cord Onset Time Respiratory Muscle Neuromuscular Blockade Effect Compartment
Unable to display preview. Download preview PDF.
- Debaene B, Meistelman C, Donati F, Lienhart A: Monitoring the onset of neuromuscular blockade at the orbicularis oculi can predict good intubating conditions when using 2XED95 of atracurium. Br J Anaesth. 70: A142, 1993.Google Scholar
- Mircea N, Constantinescu C, Jiana E, Constantinescu N, Daschievici, Straja D, Ungureana D, Leoreanu A: Ultrarapid induction. Acta Anaesthesiol Belg. 2: 61–69, 1985.Google Scholar
- Plaud B, Proost JH, Wierda JMKH, Debaene B, Barre J, Meistelman C: Concentrationeffect relationship at the vocal cords and the adductor pollicis following rocuronium administration. Br J Anaesth. 70: 1 141, 1993.Google Scholar