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British Journal of Anaesthesia, 1988, Vol. 60, No. 1 31-35
© 1988 The Board of Management and Trustees of the British Journal of Anaesthesia

research-article

POST-TETANIC COUNT AND PROFOUND NEUROMUSCULAR BLOCKADE WITH ATRACURIUM INFUSION IN PAEDIATRIC PATIENTS

S. A. RIDLEY, M.B., B.S., F.F.A.R.C.S. and D. J. HATCH, M.B., B.S., F.F.A.R.C.S.

Department of Anaesthetics, The Hospital for Sick Children Great Ormond Street, London WC1N 3JH.

In 38 paediatric surgical patients given atracurium by infusion, the degree of neuromuscular blockade was monitored using the post-tetanic twitch response. This was assessed by counting the number of visible responses when single twitch stimulation was applied at 1 Hz for 30 s after a 5-s tetanic stimulation at 50 Hz. A post-tetanic count of less than 10 correlated with a single twitch height of less than 5% of control, and ensured adequate paralysis. Once the count was greater than 15, the blockade could be antagonized readily.


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