| Clinieal Study on the Residual Effect of Pancuronium Bromide after Anesthesia. |
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Young Joon Chin, Kyoo Sub Chung |
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Department of Anesthesiology, College of Medicine, Pusan National University, Pusan, Korea. |
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| Abstract |
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The residual effect of muscle relaxant given during anesthesia can be assessed by clinical evaluation or by the use of peripheral nerve stimulator. Clinical evaluation of the recovery from neuromuscular blockade is often accompanied by some dangers of residual curarization after anesthsia because many of patinets evaluated by subjective clinical performance often have train-of-four ratio of less than 0.7 that is usually taken to reflect adequate reovery.
Clinically the magnitude of antagonism of neuromuscular blockade appears to be dependent on the amount of muscle twitch at the time of anticholinesterase administration rather than on the total dose of muscle relaxant given during anesthesia. Authors evaluated the residual effect of pancuronium after anesthesia by the use of train-of-four(TOF) stimulation to the ulnar nerve. The degree of muscle relaxation was assessed by the train-of-four count, according to which varied dose of anticholinesterase was administered and the reversal time to a train-of-four ratio of 0.7 was checke.The result of this study is summerized below. 1) Reversal time without administration of neostigmine from 4th response to a TOF stimulation to a TOF ratio of 0.7 was 45.4+/-9.3 min. 2) Reversal time to a TOF ratio of 0.7 after adminstration of neostigmine 20ug/kg the 4th response to a FOF stimulation was 14.2+/-3.2 min. 3) Reversal time to a TOF ratio of 0.7 after administration of neostigmine 25ug/kg at the 3rd response to a TOF stimulation was 14.9+/- 4.7 min. 4) Reversal time to a TOF ratio of 0.7 after administration of neostigmine 40ug/kg at the 2nd response to a TOF stimulation was 10.6+/-3.4 min. |
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