Advertisement

Differences of Onset of Different Muscles in Man and Their Consequences on Monitoring of Neuromuscular Transmission

  • Claude Meistelman
Conference paper

Abstract

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.

Keywords

Vocal Cord Onset Time Respiratory Muscle Neuromuscular Blockade Effect Compartment 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Bragg P, Fisher DM, Shi J, Donati F, Meistelman C, Lau B, Sheiner LB: Comparison of twitch depression of the adductor pollicis and the respiratory muscles. Anesthesiology. 80: 410–419, 1994.CrossRefGoogle Scholar
  2. Chauvin M, Lebrault C, Duvaldestin P: The neuromuscular blocking effect of vecuronium on the human diaphragm. Anesth Analg. 66: 117–122, 1987.PubMedCrossRefGoogle Scholar
  3. 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
  4. Donati F, Meistelman C, Plaud B: Vecuronium neuromuscular blockade at the diaphragm, the orbicularis oculi and adductor pollicis muscles. Anesthesiology. 73: 870–875, 1990.PubMedCrossRefGoogle Scholar
  5. Donati F, Meistelman C, Plaud B: Vecuronium neuromuscular blockade at the adductor muscles of the larynx and adductor pollicis in humans. Can J Anaesth. 39: 665–669, 1992.PubMedCrossRefGoogle Scholar
  6. Meistelman C, Plaud B, Donati F: Rocuronium (ORG 9426) neuromuscular blockade at the adductor muscles of the larynx and adductor pollicis in humans. Can J Anaesth. 39: 665–669, 1992.PubMedCrossRefGoogle Scholar
  7. 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
  8. Pansart JL, Chauvin M, Lebrault C, Gauneau P, Duvaldestin P: Effect of an intubating dose of succinylcholine and atracurium on the diaphragm and the adductor pollicis in humans. Anesthesiology. 67: 326–330, 1987.CrossRefGoogle Scholar
  9. 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
  10. Smith CE, Donati F, Bevan DR: Differential effects of pancuronium on masseter and adductor pollicis muscles in humans. Anesthesiology. 71: 57–61, 1989.PubMedCrossRefGoogle Scholar
  11. Stanski DR, Ham J, Miller RD, Sheiner LB: Pharmacokinetics and pharmacodynamics of d-tubocurarine during nitrous oxide-narcotic and halothane anesthesia in humans. Anesthesiology, 51: 235–241, 1979.PubMedCrossRefGoogle Scholar
  12. Ungureanu D, Meistelman C, Frossard J, Donati F: The orbicularis oculi and the adductor pollicis muscles as monitors of atracurium block of laryngeal muscles. Anesth Analg, 77: 775–779, 1993.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Japan 1995

Authors and Affiliations

  • Claude Meistelman
    • 1
  1. 1.Department of Anaesthesia, Hôpital de BraboisUniversité de NancyNancyFrance

Personalised recommendations