• S S Gill, F Donati, and D R Bevan.
• Department of Anaesthesia, Royal Victoria Hospital, Montreal, Quebec, Canada.
• Anaesthesia. 1990 Jul 1;45(7):543-8.

AbstractDouble-burst stimulation was compared with train-of-four stimulation in 23 adult patients receiving atracurium. Train-of-four was interrupted in 11 subjects every 2 minutes by one double-burst stimulation, and re-applied 6-30 seconds later; the height of the first double-burst response, compared with its control, was depressed slightly more than T1. The relationship between double-burst stimulation ratio and train-of-four ratio was indistinguishable from the line of identity. The train-of-four response, if repeated more than 12 seconds after double-burst stimulation, was not depressed compared with pre double-burst stimulation values. Fifteen anaesthetists were asked to detect fade manually in the second part of the study, while train-of-four was recorded on the opposite arm. One hundred and fourteen determinations were made in 12 patients. Fade was detected manually more often with double-burst stimulation than with TOF.

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