Compared with the Relaxometer mechanomyograph, the neuromuscular transmission module could equally indicate time to tracheal intubation and full recovery from 0.6 mg/kg rocuronium neuromuscular block. Its small quick-fit sensor has the advantage, in an often crowded and busy operating room, of being incorporated in the AS/3(TM) anesthesia workstation.

We have demonstrated a significant reduction in the Cl(c) and a prolongation of t1/2 ss of remifentanil in end-stage renal failure patients. While statistically significant, these variations in the pharmacokinetics of remifentanil were clinically modest and may be explained by a reduced volume of distribution in the period following hemodialysis.

The ParaGraph is a new device for monitoring neuromuscular function using a piezoelectric motion sensor. In 20 patients, monitoring of neuromuscular block produced by cisatracurium 0.1 mg kg-1 was compared using the ParaGraph and a Relaxometer 2 mechanomyograph. The ParaGraph was quick to set up, and easy to operate and interpret. There were no significant differences in the time to 100% depression of T1/T0, time to 25% recovery of T1/T0 or time to recovery of T1/T0 from 25% to 75%, measured by the two monitors. When the difference between the two monitors was plotted against the average of the two measurements, the limits of agreement for T1/T0 (-42.95, +53.98%) and the train-of-four ratio, T4/T1 (-0.28, +0.21) were too wide to allow the values given by the two monitors for individual patients to be used interchangeably.

ListPurpose: To compare recovery parameters of total intravenous anesthesia (TIVA) with remifentanil and propofol, hemodynamic responses to perioperative events, and pharmacodynamic parameters of cisatracurium in 22 end-stage renal failure and 22 normal renal function patients. Methods: Anesthesia was induced with 2-3 mg-kg -~ propofol and I/~gkg -~ remifentanil and maintained with 75 /Jg.kg -I 'min -j propofol and propofol initial infusion of 0.2/Jg'kg -~ 'min -~ propofol. Arterial pressure and heart rate were maintained by remifentanil infusion rate adjustments. The first twitch (TI) was maintained at 25% by an infusion of cisatracurium. Results: There was no difference in the time to maintenance of adequate respiration, date of birth recollection, first analgesic administration, between the renal failure (4.8 _+ 2.5, 7.8 + 3.2, 12.3 + 5.3 min respectively) and the control group (5.2 _+ 2.8, 8. I _+ 3. I, 12.7 _+ 5.5 min): nor were there any differences in the time to 25% T I recovery, T I recovery from 25% to 75%, or cisatracurium infusion rate between the renal failure group (32. I + 10.8 min, 18.2 -+ 5.5 min, 0.89 _+ 0.29/ag'kg -L'min -I respectively) and the control group (35.9 (7.9 rain, 18.4 _+ 3.8 min, 0.95 -+ 0.22/Jg-kg -~-min-~). Conclusion: End-stage renal failure does not prolong recovery from TIVA with remifentanil and propofol, or the recovery from cisatracurium neuromuscular block.Objectff : Comparer les param&res de la rEcupEration aprEs une anesthEsie exclusivement intraveineuse (AEI) avec du rEmifentanil et du propofol, les rEponses hEmodynamiques aux circonstances p&iop&atoires et les param&res pharmacodynamiques du cisatracurium chez 22 patients au stade d'insuffisance rEnale terminale (SIR-I-) et chez 22 patients sans problEme renal. M~thode : I'anesth&ie a EtE induite avec 2-3 mg-kg -t de propofol et I/Jg-kg -~ de rEmifentanil et maintenue avec 75 Hgkg -~-min -~ de propofol et une perfusion initiale de 0,2/~g.kg -I.min -~ de propofol. La tension art&ielle et la fr~quence cardiaque ont ~t~ maintenues par des ajustements de la vitesse de perfusion de rEmifentanil. La premiere stimulation musculaire (twitch Ti) a EtE maintenue ~ 25 % par une perfusion de cisatracurium. l~sultats : Aucune difference n'a EtE not&, quant au temps n&essaire au maintien d'une respiration adequate, au rappel de sa date de naissance et fi I'administration d'un premier analg&ique, entre les groupes SIRT (4,8 _+ 2,5;7,8 _ 3,2; 12,3 + 5,3 min respectivement) et tEmoin (5,8;8,1 _ 3,1; 12,7 + 5,5 min). Egalement, aucune difference de temps n&essaire ~ la rEcupEration d'un T~ ~ 25 %, d'un T~ de 25 % ~. 75 %, ou de vitesse de perfusion du cisatracurium, entre les groupes SIRT (32,1 _ 10,8 min; 18,2 -+ 5,5 min; 0,89 _+ 0,29 /~g.kg -I.min -I respectivement) et tEmoin (35,9 + 7,9 min; 18,4 _+ 3,8 min; 0,95 -+ 0,22/./g'kg -I'min-I). Conclusion : Le stade d'insufi]sance rEnale terminale ne prolonge pas la rEcupEration apr& I'AEI avec du rEmifentanil et du propofol ou la rEcupEration aprEs un blocage neuromusculaire avec du cis...

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