A comparison between the flexor hallucis brevis and adductor pollicis muscles in atracurium-induced neuromuscular blockade using acceleromyography: A prospective observational study

BACKGROUND Neuromuscular blockade (NMB) monitoring is essential to avoid residual NMB. While the adductor pollicis is the recommended site for monitoring recovery, it is not always accessible. The flexor hallucis brevis could be an interesting alternative. OBJECTIVE The aim of our study was to compare NMB onset and recovery at both sites. DESIGN Prospective observational study. SETTING Operating rooms at the University Hospital of Poitiers, France. PATIENTS Sixty patients scheduled for surgery under general anaesthesia with neuromuscular blocking agents were enrolled from January 2016 to September 2017. Data from 56 patients were finally analysed. Among these, 11 patients received pharmacological reversal with neostigmine and atropine before emergence from anaesthesia. INTERVENTION After atracurium injection, NMB onset and recovery at the adductor pollicis and flexor hallucis brevis were monitored simultaneously. MAIN OUTCOME MEASURES The time to NMB onset, defined as a train-of-four (TOF) count equal to 0, and the times to NMB recovery: TOF = 1, TOF = 4, T4/T1 ratio = 0.75 and T4/T1 ratio more than 0.90. RESULTS NMB onset was significantly slower at the flexor hallucis brevis with a mean onset time of 4.4 ± 1.5 versus 3.7 ± 1.2 min at adductor pollicis (P = 0.0001). Recovery to TOF = 1 was significantly slower at flexor hallucis brevis. No difference was found for TOF = 4. The full recovery of NMB (T4/T1...
Source: European Journal of Anaesthesiology - Category: Anesthesiology Tags: Neuromuscular blocking agents Source Type: research

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Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research
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Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research
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Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research
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Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research
This article combines well-established and contemporary information to summarize a systems-based approach to traditional neonatal physiology.
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research
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Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research
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Source: Molecular Medicine Reports - Category: Molecular Biology Tags: Mol Med Rep Source Type: research
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Source: Sensors and Actuators B: Chemical - Category: Chemistry Source Type: research
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Source: The Journal of the American Academy of Orthopaedic Surgeons - Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research
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Source: Current Medical Imaging Reviews - Category: Radiology Tags: Curr Med Imaging Rev Source Type: research
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