Correlation Between Integrated Evoked Emg and Respiratory Function Following Atracurium Administration

Sharpe, Michael D.; Lam, Arthur M.; Nicholas, Fallon; Chung, David C.; Merchant, Richard; Alyafi, Walid; Beauchamp, Richard

doi:10.1097/00000542-198709001-00608

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“…Submaximal neuromuscular block using pancuronium 1.6-1.8 mg has also been reported to produce a significant decrease in inspiratory capacity, maximum inspiratory flow and peak expiratory flow rates [14]. In another study using five healthy volunteers receiving an infusion of atracurium, tidal volume did not change despite significant changes in NIP, FVC and FEV, [15].…”

Section: Discussionmentioning

confidence: 93%

Pulmonary function and head lift during spontaneous recovery from pipecuronium neuromuscular block

Mikatti

Wilson

Pollard

et al. 1995

British Journal of Anaesthesia

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We have studied in seven healthy conscious volunteers the correlation between the electromyographic (EMG) and clinical criteria used to identify adequate recovery from sub-paralysing doses of pipecuronium. Pipecuronium (mean dose 1.88 (range 0.92-3.16) mg) was administered to reach a T4/T1 ratio of 0.5; full recovery to 1.0 was produced in a mean time of 25.3 (14-39) min. During recovery from neuromuscular block, we measured tidal volume, forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1) negative inspiratory pressure (NIP), peak expiratory flow rate (PEFR), mid-expiratory flow rate (MEFR) and 5-s head lift. The assessments were started when the train-of-four (TOF) ratio reached 0.5 +/- 0.001 and repeated at each 0.1 +/- 0.001 increase up to a ratio of 1.0. All volunteers showed ptosis and diplopia after the first dose and difficulty in swallowing with subsequent doses. They also experienced a pleasant, relaxing sedative sensation. All could sustain head lift for 5 s at a TOF ratio of 0.5 and higher, except for one subject who could not lift his head only at a ratio of 0.5. There was a statistically significant decrease in FVC, FEV1 and PEFR with a nonsignificant decrease in other pulmonary measurements, except for NIP which only decreased significantly at a ratio of 0.5. These changes are probably of no clinical importance. All the measured respiratory variables returned to control values at a TOF ratio of 0.9.

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Section: Discussionmentioning

confidence: 93%