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Revista Brasileira de Anestesiologia
Print version ISSN 0034-7094
NUNES, Rogean Rodrigues. Evaluation of orbicularis oculi, adductor pollicis and flexor hallux muscles responses to train of four stimulation. Rev. Bras. Anestesiol. [online]. 2001, vol.51, n.4, pp. 311-318. ISSN 0034-7094. http://dx.doi.org/10.1590/S0034-70942001000400006.
BACKGROUND AND OBJECTIVES: Neuromuscular blockers (NMB) were a landmark in the practice of anesthesiology. However, one of the problems related to the use of NMBs is postoperative residual curarization. This study aimed at comparing responses of three different muscles to the train of four stimulation during induction and regression of rocuronium-induced neuromuscular blockade. METHODS: Participated in this study 30 women physical status ASA I, aged 20 to 40 years submitted to general anesthesia. In the operating room patients were sedated with intravenous 10 mg.kg-1 alfentanil and supramaximal responses of orbicularis oculi, adductor pollicis and adductor hallucis were obtained. Anesthesia was then induced with intravenous propofol (3.5 mg.kg-1) and alfentanil (50 mg.kg-1). All patients received intravenous rocuronium (0.6 mg.kg-1) and sevoflurane for the maintenance of anesthesia. Train of four responses of different muscles were evaluated at every 14 seconds during installation and recovery T4/T1 of 0.25, 0.50, 0.75 and 0.90. Intubation was performed at the fastest relaxation moment of studied muscles and was evaluated by the proposed scale. RESULTS: Mean onset of action for orbicularis oculi, adductor pollicis and adductor hallucis was 64.8, 131.3 and 196.1 seconds, respectively. Mean recovery time of T4/T1 0.9 was 59.1, 96.4 and 65.4, respectively. Tracheal intubation conditions were considered excellent in all cases. CONCLUSIONS: Our results showed that satisfactory conditions for tracheal intubation can be achieved based the orbicularis oculi response to the train of four stimulation. However, during recovery, the highest safety margin was obtained with the adductor pollicis monitoring.
Keywords : MEASUREMENT TECHNIQUES [acceleromyography]; MONITORING [neuromuscular function]; TRACHEAL INTUBATION; NEUROMUSCULAR BLOCKERS, Nondepolarizing [rocuronium].