• Yale J Biol Med · Sep 1993

    Review

    Monitoring of neuromuscular function in the clinical setting.

    • D Kelly and S J Brull.
    • Department of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut.
    • Yale J Biol Med. 1993 Sep 1; 66 (5): 473-89.

    AbstractThis paper will review the basics of neurostimulation in the perioperative period. Following a brief overview of neuromuscular physiology, the mechanism of action of depolarizing and non-depolarizing relaxants will be discussed. The principles of neurostimulation will then be applied clinically when different patterns of stimulation (single twitch, train-of-four, post-tetanic twitch count, double burst) are described. Clinical assessment of neuromuscular function will then be compared with both subjective and objective means of assessment of adequacy of intraoperative relaxation and postoperative reversal. The principles reviewed in this paper will then be applied in the clinical setting, and risks and benefits associated with perioperative use of muscle relaxants will be discussed.

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