Differential effect of pancuronium at the adductor pollicis, the first dorsal interosseous and the hypothenar muscles. An electromyographic and mechanomyographic dose‐response study

Abstract

Cumulative dose-response curves were constructed from evoked compound electromyographic (EMG) recordings in man to compare the sensitivity to pancuronium of the adductor pollicis, the hypothenar and the first dorsal interosseous muscles. Also, the EMG and mechanomyography-based sensitivity of the adductor pollicis muscle were compared. The EMG and the mechanomyogram were evaluated in random sequence in each of 21 adult thiopental, fentanyl and diazepam anesthetized patients. The EMG-based ED50 were 36-38 micrograms.kg-1 with no differences between muscles. The EMG-based ED90 of the adductor pollicis and the hypothenar muscles were 62-65 micrograms.kg-1 compared to the 60 micrograms.kg-1 of the first dorsal interosseous muscle (P < 0.05). ED50 (34 micrograms.kg-1), and ED90 (56 micrograms.kg-1) obtained from the adductor pollicis mechanomyogram were significantly lower than those based on the EMG (P < 0.05). It is concluded that differences in sensitivity to pancuronium exist between the three muscles when evaluated from the EMG, and that the apparent sensitivity of a given muscle to a muscle relaxant may depend upon whether the response is evaluated using EMG or mechanomyography.

Effect of isoflurane and sevoflurane on the magnitude and time course of neuromuscular block produced by vecuronium, pancuronium and atracurium

“…Similar observations have been made previously with tubocurarine [14]. The results of the current study are at variance with those of Engbaek and Roed [15] using pancuronium. Their findings may be explained by different con ditions of anaesthesia, or recording electrode positioning [16] and stimulation frequency, or both [17].…”

Recovery of post-tetanic and train-of-four responses at the first dorsal interosseous and adductor pollicis muscles in patients receiving vecuronium

“…To measure only the response of the DI, electromyography should be used in place of the accelograph as in two previous studies. 5,6 In the present study succinylcholine 1 mg-kg -~ was administered to facilitate tracheal intubation. Approximately 20 min after succinylcholine, the control value (Ti/T0) was obtained and, thereafter, vecuronium was administered.…”

Phonomyographic measurements of neuromuscular blockade are similar to mechanomyography for hand muscles

“…4,[11][12][13] Whereas some studies have found practically interchangeable results for all intrinsic hand muscles, some work has indicated that the hypothenar muscles are more resistant to neuromuscular blocking agents than the thenar muscles. 14 Furthermore, electromyography has been shown to differ significantly from mechanomyographical results 13,15,16 and is rarely used for research purposes or in clinical routine. PMG offers the advantage of easy setup, applicability in research and clinical routine, and differentiation between different hand muscles.…”