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Double burst stimulation with submaximal current

N Ueda1, Y Masuda, T Muteki

  • 1Department of Anaesthesiology, Kurume University School of Medicine, Fukuoka, Japan.

European Journal of Anaesthesiology
|September 1, 1994
PubMed
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This study shows that double burst stimulation (DBS) at 30 mA accurately assesses neuromuscular blockade in patients. Reducing current to 30 mA offers reliable results without patient discomfort.

Area of Science:

  • Anesthesiology
  • Neuromuscular Monitoring

Background:

  • Supramaximal stimulation during neuromuscular blockade assessment can cause discomfort in awake patients.
  • Double burst stimulation (DBS) is a common method for evaluating residual neuromuscular blockade.

Purpose of the Study:

  • To investigate the reliability of submaximal (30 mA) double burst stimulation (DBS) for assessing neuromuscular blockade.
  • To compare the accuracy of 30 mA DBS with supramaximal stimulation.

Main Methods:

  • Neuromuscular responses to DBS (DBS3.3, DBS3.2) and train-of-four (TOF) stimulation were recorded using mechanomyography in 30 adult patients.
  • Ratios of T4/T1 (TOF) and D2/D1 (DBS) were calculated at supramaximal and submaximal (30 mA) currents.
  • Regression analysis was used to compare T4/T1 ratios with D2/D1 ratios.

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Main Results:

  • No statistical difference was found between T4/T1 ratios from supramaximal TOF and D2/D1 ratios from supramaximal DBS3.3.
  • No significant difference was observed between T4/T1 ratios and D2/D1 ratios from submaximal DBS3.3.
  • Similar findings were noted for DBS3.2, indicating consistent reliability.

Conclusions:

  • Evaluation of neuromuscular blockade using double burst stimulation (DBS) at 30 mA is as reliable as using supramaximal currents.
  • Submaximal DBS offers a comfortable and accurate alternative for monitoring neuromuscular blockade in awake patients.