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British Journal of Anaesthesia, 2000, Vol. 85, No. 2 251-255
© 2000 The Board of Management and Trustees of the British Journal of Anaesthesia

Comparison of succinylcholine with two doses of rocuronium using a new method of monitoring neuromuscular block at the laryngeal muscles by surface laryngeal electromyography

T. M. Hemmerling1,*, J. Schmidt1, T. Wolf1, P. Klein2 and K. Jacobi1

Departments of 1Anaesthesiology and 2Surgery, University of Erlangen, Nuremberg, Germany

We compared the onset of neuromuscular block with succinylcholine (1 mg kg–1) and two doses of rocuronium (0.6 and 0.9 mg kg–1) at the adductor pollicis muscle using electromyography (EMG) and acceleromyography (AMG), and at the adductor laryngeal muscles with a new electromyographic method using a disposable surface electrode attached to the cuff of a tracheal tube. At the larynx, the mean (±SD) time to 90% block and the onset time of succinylcholine (38±15 and 47±19 s, respectively) were significantly shorter (P<0.01) than for rocuronium 0.6 mg kg–1 (92±42 and 106±38 s) and rocuronium 0.9 mg kg–1 (52±31 and 64±30 s). We found that, with comparable degrees of neuromuscular block, the onset time of succinylcholine at the adductor pollicis was significantly shorter (P<0.01) than for rocuronium 0.6 mg kg–1 and 0.9 mg kg–1 (EMG, 80±39 vs 145±48 s and 99±31 s; AMG, 90±39 vs 124±53 s and 106±38 s). Clinical duration at the adductor pollicis (AMG) was significantly longer (P<0.01) for both rocuronium groups than for succinylcholine (T4:T1=0.7, 54±18 and 77±21 vs 8±6 min). The surface laryngeal electrode proved non-invasive, easy to use and reliable in measuring onset of the neuromuscular block at the larynx.

Br J Anaesth 2000; 85: 251–5

* Corresponding author: Postfach 1367, D-66363 St Ingbert, Germany


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