The effect of changes in arm temperature on neuromuscular monitoring in the presence of atracurium blockade

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Abstract
This study was designed to investigate the relationship between arm temperature and the degree of blockade as monitored by peripheral nerve stimulation by a comparison of both arms of each patient; one exposed to the environment and the other wrapped to maintain its temperature. The decrease in the temperatures of the exposed arms were significantly more than the wrapped arms. A discrepancy was noted proportional to the temperature difference between the two arms, when the train-of-four counts were compared. A recommendation is made to maintain the temperature of the monitored arm above 32 degrees C.