• Br J Anaesth · Jun 1977

    Neuromuscular facilitation during train-of-four and tetanic stimulation in healthy volunteers: observations with half-refractory paired responses.

    • C Lee, A Barnes, E Yang, and R L Katz.
    • Br J Anaesth. 1977 Jun 1; 49 (6): 555-60.

    AbstractThe compound electromyographic response of the thenar musculature was elicited by supramaximal stimulation of the ulnar nerve in 12 awake healthy volunteers. The half-refractory period of the neuromuscular transmission was determined. Twin stimuli separated by the half-refractory interval were repeated as a unit at 2 Hz and at 50 Hz. Thus two trains of responses, one beginning with a maximal response, the other with a half-maximal response, were obtained with each frequently of stimulation. Marked facilitation of the electromyographic response began with the train of stimulation, especially with tetanic stimulation. A secondary fade occurred occasionally. These changes were more remarkable in the train of half-refractory responses. We conclude that nerve stimulation facilitates neuromuscular transmission and deduce that the characteristic fade observed with a curariform block, rather than being an uncovered physiological phenomenon, is caused by tubocurarine and related drugs.

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