The effect of a tetanic stimulus on the response to subsequent tetanic stimulation. 1993

D G Silverman, and S J Brull
Department of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut 06510.

We evaluated the effect of tetanic stimulation (5 s, 50 Hz, 60 mA) on the response to tetanic stimulation delivered 2 min (TET@2) and 5 min (TET@5) later in 22 anesthetized patients receiving a vecuronium infusion. Once a consistent mechanomyographic train-of-four ratio was obtained at the adductor pollicis muscle, the first (baseline) tetanic stimulus was delivered. Tetanic sequences were repeated randomly after 2- and 5-min intervals. Tetanic fade was consistent among the study periods: the tetanic fade ratio for the first second of tetanus was 0.35 during baseline tetanic stimulation, 0.32 during TET@2 (P = NS by paired t-test), and 0.33 during TET@5 (P = NS). The respective fade ratios for the entire 5-s period were 0.15, 0.15 (P = NS), and 0.14 (P = NS). In contrast, the peak tetanic height increased from 10.8 mm at baseline to 11.3 mm at TET@2 (P < 0.05), and 11.3 mm at TET@5 (P < 0.05). We conclude that, in light of the consistency exhibited by tetanic fade, the small change in twitch height is clinically insignificant.

UI MeSH Term Description Entries
D007262 Infusions, Intravenous The long-term (minutes to hours) administration of a fluid into the vein through venipuncture, either by letting the fluid flow by gravity or by pumping it. Drip Infusions,Intravenous Drip,Intravenous Infusions,Drip Infusion,Drip, Intravenous,Infusion, Drip,Infusion, Intravenous,Infusions, Drip,Intravenous Infusion
D009119 Muscle Contraction A process leading to shortening and/or development of tension in muscle tissue. Muscle contraction occurs by a sliding filament mechanism whereby actin filaments slide inward among the myosin filaments. Inotropism,Muscular Contraction,Contraction, Muscle,Contraction, Muscular,Contractions, Muscle,Contractions, Muscular,Inotropisms,Muscle Contractions,Muscular Contractions
D009469 Neuromuscular Junction The synapse between a neuron and a muscle. Myoneural Junction,Nerve-Muscle Preparation,Junction, Myoneural,Junction, Neuromuscular,Junctions, Myoneural,Junctions, Neuromuscular,Myoneural Junctions,Nerve Muscle Preparation,Nerve-Muscle Preparations,Neuromuscular Junctions,Preparation, Nerve-Muscle,Preparations, Nerve-Muscle
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000770 Anesthesia, Endotracheal Procedure in which an anesthetic such as a gas or mixture of gases is inhaled through a tube into the lungs. Anesthesia, Intratracheal,Endotracheal Anesthesia,Intratracheal Anesthesia,Anesthesias, Endotracheal,Anesthesias, Intratracheal,Endotracheal Anesthesias,Intratracheal Anesthesias
D013746 Tetany A disorder characterized by muscle twitches, cramps, and carpopedal spasm, and when severe, laryngospasm and seizures. This condition is associated with unstable depolarization of axonal membranes, primarily in the peripheral nervous system. Tetany usually results from HYPOCALCEMIA or reduced serum levels of MAGNESIUM that may be associated with HYPERVENTILATION; HYPOPARATHYROIDISM; RICKETS; UREMIA; or other conditions. (From Adams et al., Principles of Neurology, 6th ed, p1490) Spasmophilia,Tetany, Neonatal,Tetanilla,Neonatal Tetanies,Neonatal Tetany,Spasmophilias,Tetanies,Tetanies, Neonatal,Tetanillas
D013997 Time Factors Elements of limited time intervals, contributing to particular results or situations. Time Series,Factor, Time,Time Factor
D014673 Vecuronium Bromide Monoquaternary homolog of PANCURONIUM. A non-depolarizing neuromuscular blocking agent with shorter duration of action than pancuronium. Its lack of significant cardiovascular effects and lack of dependence on good kidney function for elimination as well as its short duration of action and easy reversibility provide advantages over, or alternatives to, other established neuromuscular blocking agents. NC-45,Norcuron,ORG-NC 45,ORG-NC-45,ORG-NC45,Vecuronium,Vecuronium Bromide, Quaternary Ion,Vecuronium Citrate,Vecuronium Hydrobromide,Vecuronium Hydrochloride,Vecuronium Maleate,Vecuronium Phosphate,Bromide, Vecuronium,Citrate, Vecuronium,Hydrobromide, Vecuronium,Hydrochloride, Vecuronium,Maleate, Vecuronium,NC 45,NC45,ORG NC 45,ORG NC45,ORGNC 45,ORGNC45,Phosphate, Vecuronium

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