REAPPEARANCE OF THE TRAIN-OF-FOUR AFTER NEUROMUSCULAR BLOCKADE INDUCED WITH TUBOCURARINE, VECURONIUM OR ATRACURIUM

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Abstract
The characteristics of train-of-four recovery after atracurium or vecuronium were studied, under enflurane anaesthesia, and compared with those associated with tubocurarine-induced blockade. Ten patients each received vecuronium 0.1 mg kg−1 atracurium 0.5 mg kg−1 or tubo-curarine 0.5 mg kg−1. Neuromuscular blockade was calculated as the percent depression of the first twitch, and was determined at the time of reappearance of the second, third and fourth twitches of the train-of-four. The pattern during recovery from blockade induced by the three neuromuscular blocking agents was similar, with T2, T3andT4 reappearing at approximately 93 %, 89% and 86% residual blockade, respectively. These results are different from those previously reported by Lee (1975) indicating that, under enflurane anaesthesia, the train-of-four count may give an incorrect estimate of the degree of neuromuscular blockade.