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British Journal of Anaesthesia, 1994, Vol. 73, No. 3 416-417
© 1994 The Board of Management and Trustees of the British Journal of Anaesthesia

research-article

Effect of tetanic stimulation on subsequent train-of-four responses at various levels of vecuronium-induced neuromuscular block

Y. SAITOH, MD, A. MASUDA, MD, H. TOYOOKA, MD and K. AMAHA, MD

Department of Anaesthesiology and Critical Care Medicine, Faculty of Medicine, Tokyo Medical and Dental University 5-45, Yushima, 1-Chome, Bunkyo-ku, Tokyo 113, Japan

Tetanic stimulation influences subsequent neuromuscular responses. In addition, the tetanus- induced changes in neuromuscular responses differ according to the level of neuromuscular block at which tetanic stimulation is delivered. We studied the tetanus-induced effect on subsequent train-of-four (TOF) responses at various levels of vecuronium-induced neuromuscular block in 45 anaesthetized patients. Tetanic stimulation was applied when a twitch height of T1 returned to 25%, 50% and 75% of its control twitch height (T0) (groups 1, 2 and 3, respectively) after administration of vecuronium 0.1 mg kg–1. Maximum post-tetanic percentage increases in TOF responses in groups 1, 2 and 3 were 257 (SD 119)%, 107 (75)% and 68 (54)% for T1/T0 (P < 0.001 for group 1 vs 2; P < 0.001 for group 1 vs 3) and 535 (259)%, 421 (213)% and 292 (171)% for T4/T1 (P < 0.01 for group 1 vs 3), respectively. Durations of post-tetanic increases in TOF responses in groups 1, 2, and 3 were 52 (19)s, 37 (14)s, and 32 (13) s for T1/T0 (P / 0.05 for group 1 vs 2; P < 0.01 for group 1 vs 3) and 53 (17)s, 46 (15)s and 35 (12)s for T4/T1 (P < 0.05 for group 1 vs 3), respectively. These data suggest that the tetanus-induced effect on subsequent TOF is more apparent and lasts longer at greater degrees than at lesser degrees of neuromuscular block.


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