Anaes SAQs · Neuromuscular blockade & reversal
Train-of-four monitoring and residual blockade
Short-answer question on train-of-four monitoring, block patterns, and the safe-extubation threshold.
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Prompt
Describe the train-of-four method of neuromuscular monitoring, how it distinguishes depolarising from non-depolarising block, and the criteria for safe extubation.
Question
Describe the train-of-four method of neuromuscular monitoring, how it distinguishes depolarising from non-depolarising block, and the criteria for safe extubation.
[1]References7ShowHide
- [1]Thilen SR, et al. 2023 American Society of Anesthesiologists Practice Guidelines for Monitoring and Antagonism of Neuromuscular Blockade: A Report by the American Society of Anesthesiologists Task Force on Neuromuscular Blockade. Anesthesiology, 2023.PMID 36520073
- [2]Viby-Mogensen J, et al. Posttetanic count (PTC): a new method of evaluating an intense nondepolarizing neuromuscular blockade. Anesthesiology, 1981.PMID 7294384
- [3]Krönauer T, Girrbach F, Simon P, et al. [Muscle relaxation and neuromuscular monitoring : Current findings and recommendations for the clinical practice]. Die Anaesthesiologie, 2026.PMID 42334564
- [4]Blobner M, et al. Use of a train-of-four ratio of 0.95 versus 0.9 for tracheal extubation: an exploratory analysis of POPULAR data Br J Anaesth, 2020.PMID 31607388
- [5]Brull SJ, Silverman DG Visual and tactile assessment of neuromuscular fade Anesth Analg, 1993.PMID 8394051
- [6]Eriksson LI Reduced hypoxic chemosensitivity in partially paralysed man. A new property of muscle relaxants? Acta Anaesthesiol Scand, 1996.PMID 8792879
- [7]Sundman E, Witt H, Olsson R, Ekberg O, Kuylenstierna R, Eriksson LI The incidence and mechanisms of pharyngeal and upper esophageal dysfunction in partially paralyzed humans: pharyngeal videoradiography and simultaneous manometry after atracurium Anesthesiology, 2000.PMID 10754616