International journal of clinical monitoring and computing
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Int J Clin Monit Comput · Nov 1996
Comparative StudyDouble burst monitoring during recovery from atracurium-induced neuromuscular blockade: a comparison with train-of-four.
Double burst stimulation (DBS) was originally introduced for improved manual detection of residual neuromuscular blockade. Previous studies demonstrated a high correlation between mechanomyographical responses to DBS and train-of-four (TOF) stimulation during recovery from neuromuscular blockade. However, repeatability and bias analyses that are recommended when new monitoring devices are introduced into clinical practice [11] have not yet been performed. ⋯ The limits of agreement between DBS and TOF responses were so wide that DBS and TOF can not be used interchangeably.
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Int J Clin Monit Comput · Nov 1996
Comparative StudyPerformance assessment of an adaptive model-based feedback controller: comparison between atracurium, mivacurium, rocuronium and vecuronium.
The performance of an adaptive model-based controller for the administration of atracurium, mivacurium, rocuronium and vecuronium was compared in 159 adult surgical patients. The degree of neuromuscular block was set to 90% for atracurium, rocuronium and vecuronium and to 95% for mivacurium. ⋯ Although the controller appeared to be able to control rocuronium induced block at 90% and mivacurium induced block at 95% better than atracurium and vecuronium block at 90%, the differences in the controller performance between the four studied relaxants were small and have hardly any clinical significance. We conclude that a model-based adaptive controller is useful in the administration of atracurium, mivacurium, rocuronium or vecuronium.
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Int J Clin Monit Comput · Nov 1996
Development of a portable closed-loop atracurium infusion system: systems methodology and safety issues.
Safety of closed-loop drug infusion systems is an issue often raised as a matter of concern. As a result, many closed-loop control systems are reported in the literature merely as computer simulation studies and few ever reach the stage of physical realisation and formal clinical evaluation. ⋯ The benefits of closed-loop muscle relaxation in providing stable surgical operating conditions over a wide range of patient sensitivities while infusing the minimum amount of drug makes this a worthwhile aim and serves to demonstrate safety issues which are generally applicable to other closed-loop drug infusion systems. It is hoped that the described methodology will facilitate and encourage the clinical application of closed-loop drug infusion systems so that clinical staff and patients may receive the benefits of closed-loop drug therapy.