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British Journal of Anaesthesia, 1988, Vol. 61, No. 5 547-550
© 1988 The Board of Management and Trustees of the British Journal of Anaesthesia

research-article

USE OF THE POST-TETANIC COUNT TO MONITOR RECOVERY FROM INTENSE NEUROMUSCULAR BLOCKADE IN CHILDREN

C. L. GWINNUTT, M.B. B.S., F.F.A.R.C.S. and G. MEAKIN, M.B., CH.B., D.A., F.F.A.R.C.S.

Department of Anaesthesia, Royal Manchester Children's Hospital Pendlebury, Manchester M27 1HA

Correspondence to G. M.

The post-tetanic count was investigated as a method of monitoring intense neuromuscular blockade in children. One of five myoneural blockers (atracurium, vecuronium, pancuronium, tubocurarine or alcuronium) was given to groups of six children during nitrous oxide-oxygen-halothane anaesthesia. During recovery, the first post-tetanic response always preceded the first train-of-four response. The interval between the appearance of the first post-tetanic response and the first train-of-four response was typically 5–10 min for the intermediate-acting agents vecuronium and atracurium, and 20–30 min for the long-acting agents pancuronium, alcuronium and tubocurarine. A post-tetanic count of 6 with alcuronium and tubocurarine, or 7 with vecuronium, atracurium and pancuronium indicated that recovery of the first train-of-four response was imminent.


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