• T Ohshima, Y Fujii, H Toyooka, T Udagawa, K Yokoyama, and K Amaha.
• Department of Anesthesia, Tokyo Metropolitan, Hiroo General Hospital.
• Masui. 1990 Oct 1;39(10):1288-93.

AbstractThe role of impairment of neuromuscular transmission in fatigued canine diaphragm was investigated by comparing the function of fatigued diaphragm with that of neuromuscular junction (NMJ)-blocked diaphragm. Diaphragmatic fatigue was produced by intermittent supramaximal stimulation of bilateral phrenic nerves. Partial NMJ blockade was obtained by vecuronium bromide administered intravenously. During control study, no fade was observed either in integrated diaphragmatic electric activity (Edi) or transdiaphragmatic pressure (Pdi). In fatigued diaphragm, Edi generated by 100 Hz showed a remarkable fade. The fade was prominent in high frequency fatigue. In NMJ-blocked diaphragm, fade was observed in Pdi as well as in Edi produced by 100 Hz. The fade of Edi by 100 Hz was prominent. In low frequency fatigue, both Pdi and Edi produced by 20 Hz test stimulation were significantly lower than control values. These results show that in addition to impairment of excitation-contraction coupling, neuromuscular blockade is involved, at least in part, in low frequency diaphragmatic fatigue.

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