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British Journal of Anaesthesia, 1995, Vol. 74, No. 3 293-295
© 1995 The Board of Management and Trustees of the British Journal of Anaesthesia

research-article

Post-tetanic burst: a new monitoring method for intense neuromuscular block

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

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

A new stimulation pattern for evaluation of intense neuromuscular block (post-tetanic burst (PTB)) was compared with post-tetanic twitch (PTT) during spontaneous recovery from vecuronium-induced neuromuscular block. Thirty adult patients were allocated to two equal groups and we measured times from administration of vecuronium 0.1 mg kg–1 to return of PTB and PTT responses, and evoked responses to PTB and PTT stimuli. For PTB stimulation, a 50-Hz tetanus was applied at 50 mA for 5 s, and after a pause of 3 s, a 50-Hz burst stimulation was applied, consisting of three impulses at 50 mA. PTB stimuli were delivered every 5 min. Similarly, PTT consisted of a tetanus, a 3-s pause and one single twitch stimulation repeated every 5 min. Time to return of the PTB response was significantly shorter than that of PTT (mean 23.7 (SD 7.9) compared with 30.7 (7.0) min) (P = 0.0160), although evoked responses to PTB did not differ significantly from those of PTT throughout recovery from vecuronium-induced neuromuscular block. This study suggested that PTB was more sensitive in evaluating intense neuromuscular block than PTT. (Br. J. Anaesth. 1995; 74: 293–295)


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