British Journal of Anaesthesia, Vol 77, Issue 6 716-719, Copyright © 1996 by The Board of Management and Trustees of the British Journal of Anaesthesia
G. d'Honneur, V. Slavov, J. C. Merle, K. Kirov, J. M. Rimaniol, L. Sperry and P. Duvaldestin
Although subjects often report difficulty with swallowing shortly after
receiving neuromuscular blocking agents, difficulty with swallowing during
recovery from neuromuscular blocking agents appears to be infrequent. We
have used electromyography to compare onset and recovery at the diaphragm
and geniohyoid airway muscles after an intubating dose of mivacurium (0.2
mg kg-1) to determine if the geniohyoid muscles were particularly sensitive
to neuromuscular blocking agents. Twelve adults undergoing elective surgery
were anaesthetized with propofol and fentanyl and the trachea intubated
without neuromuscular blocking agents. The left hypoglossal and right
phrenic nerves were stimulated with percutaneous needle electrodes and the
electromyogram recorded with surface electrodes. EMG responses were
measured after a bolus dose of mivacurium 0.2 mg kg-1. Recordings were also
made of the mechanical response of the adductor pollicis to supramaximal
ulnar nerve stimulation. There was no difference in the rate of onset of
block for geniohyoid muscles and the diaphragm, but recovery to 25% and 90%
of the control response was shorter at the diaphragm (median 14.5 (95%
confidence limits 12.9-15.3) min and 23.8 (21.7-26) min) than at the
geniohyoid muscle (19.4 (15.6-20.1) min and 29.2 (26.3-31.4) min),
respectively (P < 0.05). When the train-of-four ratio of the mechanical
response of the thumb reached 70%, the diaphragm and geniohyoid muscles had
recovered completely in all patients.
CLINICAL INVESTIGATIONS
Comparison of the effects of mivacurium on the diaphragm and geniohyoid muscles
Departement d'Anesthesie-Reanimation, Hopital Henri Mondor, 51, ave du M de Lattre de Tassigny, 94010 Créteil Cedex, France
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  G. Dhonneur, K. Kirov, C. Motamed, R. Amathieu, W. Kamoun, V. Slavov, and S-K. Ndoko Post-tetanic count at adductor pollicis is a better indicator of early diaphragmatic recovery than train-of-four count at corrugator supercilii Br. J. Anaesth., September 1, 2007; 99(3): 376 - 379. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Kirov, C. Motamed, S.-K. Ndoko, and G. Dhonneur TOF count at corrugator supercilii reflects abdominal muscles relaxation better than at adductor pollicis Br. J. Anaesth., May 1, 2007; 98(5): 611 - 614. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. R. Hillman, P. R. Platt, and P. R. Eastwood The upper airway during anaesthesia Br. J. Anaesth., July 1, 2003; 91(1): 31 - 39. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Takahashi, T. Ono, Y. Ishiwata, and T. Kuroda Breathing modes, body positions, and suprahyoid muscle activity J. Orthod., December 1, 2002; 29(4): 307 - 313. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. M. Hemmerling, J. Schmidt, C. Hanusa, T. Wolf, and H. Schmitt Simultaneous determination of neuromuscular block at the larynx, diaphragm, adductor pollicis, orbicularis oculi and corrugator supercilii muscles Br. J. Anaesth., December 1, 2000; 85(6): 856 - 860. [Abstract] [Full Text] [PDF]
|
|