Acta anaesthesiologica Belgica
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The use of patient-controlled analgesia in children and adolescents undergoing major surgery is safe and effective provided that patients are carefully selected, adequate information is provided to patients, adequate training is given to hospital staff and efficacy as well as side-effects are appropriately monitored. Practical guidelines and examples of complications are given.
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Acta Anaesthesiol Belg · Jan 1992
Comparative StudyDouble burst stimulation for monitoring profound neuromuscular blockade: a comparison with posttetanic count and train of four.
Double burst stimulation (DBS) is a new nerve stimulation pattern introduced to facilitate tactile evaluation of recovery from neuromuscular blockade. DBS consists of two bursts of high frequency stimulations separated by a short time interval. The relationships between DBS, post-tetanic count (PTC) and train-of-four (TOF) on the evoked twitch response was investigated in 16 surgical patients and 7 intensive care patients given atracurium for muscle relaxation. ⋯ When the first twitch of TOF was still not measurable, the first twitch of DBS ranged from 0 to 20% of the TOF-control twitch height. Furthermore the DBS ratio was significantly correlated to the TOF ratio (r = 0.92-0.96, p < 0.0002). It is concluded that DBS not only can be used for monitoring of recovery from neuromuscular blockade, but also for monitoring of intense degrees of neuromuscular blockade.