What are some methods of monitoring the efficacy of neuromuscular blocking agents?
There are several quantitative methods of assessing neuromuscular blockade, including acceleromyogra- phy (AMG), kinemyography (KMG), electromyography (EMG), and MMG (Table 3). 7 All these methods use the ulnar nerve and adductor pollicis muscle (ie, thumb twitch).
What is postoperative residual Curarization?
Postoperative residual curarization (PORC) or residual neuromuscular blockade (RNMB) is a residual paresis after emergence from general anesthesia that may occur with the use of neuromuscular-blocking drugs.
What tests monitor residual neuromuscular blockade?
Significant residual neuromuscular block can be assessed using the TOF response. However, small degrees of residual block may be easier to appreciate with DBS. In DBS, two short bursts of tetanus at 50 Hz at a supramaximal current are applied to a nerve.
What is TOF ratio?
The muscle response can be quantified with different parameters depending on the type and the level of neuromuscular block. TOF Count is the number of detected muscle responses. Train- of-four ratio (TOF%) is the ratio of the fourth muscle response to the first one. TOF% indicates fade in non-depolarizing block.
What does Curarization mean?
cu·ra·rized, cu·ra·riz·ing, cu·ra·riz·es. 1. To poison with curare. 2. To treat with curare so as to relax the skeletal muscles.
Who discovered curare?
Richard Evans Schultes
The source of curare in the Amazon was first researched by Richard Evans Schultes in 1941. Since the 1930s, it was being used in hospitals as a muscle relaxant. He discovered that different types of curare called for as many as 15 ingredients, and in time helped to identify more than 70 species that produced the drug.
How do you measure neuromuscular function?
The most reliable method of measuring neuromuscular function is to stimulate an accessible peripheral motor nerve and measurement of the evoked response of the skeletal muscle or muscles innervated by the stimulated motor nerve.
How is rocuronium used to treat residual curarization?
Neuromuscular function monitoring and the use of the appropriate dosage of sugammadex to reverse blockade produced by rocuronium can reduce the incidence of postoperative residual curarization. In this study, with usual care group receiving reversal with neostigmine resulted in a residual blockade rate of 43%.
How many patients have residual curarization after atracurium?
A study by Debaene and colleagues 1 found that 45% of patients had residual curarization (train-of-four [TOF] ratio<0.9) in the postoperative recovery room after a single intubating dose of the intermediate-acting drugs atracurium, vecuronium or rocuronium.
What is the design and installation of a monitoring well?
The design and installation of permanent monitoring wells involves drilling into various types of geologic formations that exhibit varying subsurface conditions. Designing and installing permanent monitoring wells in these geologic environments may requir e several different drilling methods and installation procedures.
What is the definition of postoperative residual curarization?
Postoperative residual curarization ( PORC) or residual neuromuscular blockade (RNMB) is a residual paresis after emergence from general anesthesia that may occur with the use of neuromuscular-blocking drugs. Today residual neuromuscular blockade is defined as a train of four ratio…
