Related Experiment Video
Updated: Aug 6, 2026
07:53
Assessment of Neuromuscular Function Using Percutaneous Electrical Nerve Stimulation
Published on: September 13, 2015
[Clinical evaluation of neuromuscular block]
1Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Tokyo Medical and Dental University.
Masui. the Japanese Journal of Anesthesiology
|October 1, 1996
Summary
Post-tetanic count and double burst stimulation are used to assess neuromuscular block. New methods, post-tetanic burst and double burst stimulation, may offer better quantification for profound and residual neuromuscular block.
Area of Science:
- Anesthesiology and pharmacology
- Neuromuscular junction physiology
Context:
- Current methods for assessing neuromuscular block, such as post-tetanic count and double burst stimulation, have limitations.
- Evaluating profound neuromuscular block with post-tetanic count is challenging.
- Assessing adequate recovery from neuromuscular block using double burst stimulation can be insufficient.
Purpose:
- To explore the utility of post-tetanic burst and double burst stimulation for quantifying neuromuscular block.
- To address limitations in current neuromuscular block assessment techniques.
Summary:
- Post-tetanic count is used for intense neuromuscular block assessment.
- Double burst stimulation is used for residual neuromuscular block assessment.
- Post-tetanic burst and double burst stimulation show potential for improved quantification of intense and residual neuromuscular block, respectively.
Impact:
- Potential for more accurate monitoring of neuromuscular blockade depth and recovery.
- Improved patient safety through better assessment of neuromuscular function post-surgery.
- Advancement in understanding and managing neuromuscular blockade in clinical settings.
Related Concept Videos
01:29Neuromuscular Junction And Blockade
The site of chemical communication between a motor neuron and a muscle fiber is called the neuromuscular junction (NMJ). The end of the motor neuron at the NMJ divides into a cluster of synaptic end bulbs. The cytoplasm of these bulbs consists of synaptic vesicles enclosing acetylcholine molecules, the principal neurotransmitter released at the NMJ. The region opposite the synaptic bulb that ends in the muscle fiber is called the motor end plate, which has acetylcholine receptors. Within the...
01:28Classification of Skeletal Muscle Relaxants
Skeletal muscle relaxants are a group of drugs that can reduce muscle stiffness and induce temporary paralysis to relieve pain. These agents can act centrally to reduce muscle tone or spasms in painful conditions such as multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS), or spinal injuries; they are called antispasmodics or spasmolytics.
Peripherally acting skeletal muscle relaxants interfere with the neurotransmission at the neuromuscular end plate to induce paralysis during...
Peripherally acting skeletal muscle relaxants interfere with the neurotransmission at the neuromuscular end plate to induce paralysis during...
01:17Nondepolarizing (Competitive) Neuromuscular Blockers: Mechanism of Action
Nondepolarizing neuromuscular blockers induce paralysis by competitively blocking nicotinic acetylcholine receptors at the muscle end plate. Examples include pancuronium, mivacurium, vecuronium, and rocuronium. These quaternary ammonium derivatives are administered intravenously, are poorly absorbed, and are excreted via the kidneys.
Competitive antagonists prevent acetylcholine from binding to its receptor, inhibiting membrane depolarization. Without conformational changes or intrinsic...
Competitive antagonists prevent acetylcholine from binding to its receptor, inhibiting membrane depolarization. Without conformational changes or intrinsic...
01:27Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacological Actions
Nondepolarizing neuromuscular blockers prevent the membrane depolarization of muscle cells and inhibit muscle contraction. These are usually administered with anesthetics to achieve complete muscle relaxation. Upon administration, these drugs first block the small, rapidly contracting muscles of the face and hands, followed by the larger muscles of the trunk and the intercostal muscles. The diaphragm is the last muscle to be affected.
Although all competitive neuromuscular blockers are designed...
Although all competitive neuromuscular blockers are designed...
01:11Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacokinetics
All neuromuscular blocking agents are injected intravenously because they are poorly absorbed from the GI tract. Rapid onset is achieved with intravenous administration, although absorption is also adequate from an intramuscular injection. Since these agents are highly ionized, they do not readily penetrate cell membranes or cross the blood-brain barrier.
Instead, they are transported by the blood to different tissues. Muscles with a greater blood supply (arteries) and blood flow receive more...
Instead, they are transported by the blood to different tissues. Muscles with a greater blood supply (arteries) and blood flow receive more...
01:28Depolarizing Blockers: Mechanism of Action
Depolarizing blockers act on skeletal muscle fibers' membranes and induce their depolarization. Most depolarizing blockers have two quaternary N+ atoms that bind the nicotinic acetylcholine receptors and cause neuromuscular blockade within minutes.
Succinylcholine is the most commonly used depolarizing blocker. Chemically, it constitutes two molecules of acetylcholine joined together by an acetate methyl group. They act on the receptors in the same way as acetylcholine. Because succinylcholine...
Succinylcholine is the most commonly used depolarizing blocker. Chemically, it constitutes two molecules of acetylcholine joined together by an acetate methyl group. They act on the receptors in the same way as acetylcholine. Because succinylcholine...