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- W1592369226 abstract "Objective To measure twitch potentiation (the staircase phenomenon) in anesthetized dogs, and assess its relevance during neuromuscular monitoring with acceleromyography (AMG). Study design Randomized, prospective clinical trial. Animals Sixteen dogs undergoing ovariohysterectomy. Methods Under isoflurane anesthesia, neuromuscular function was monitored with train-of-four (TOF) stimuli every 15 seconds and quantified by AMG. Neuromuscular blockade (NMB) was produced with 0.15 mg kg−1 atracurium IV. Dogs were randomly divided into two groups; a potentiation group (PG) in which TOF stimulation was applied for 20 minutes before atracurium was administered; and a control group (CG) where no such time was allowed. In both groups, the AMG was calibrated (at tCAL) just before atracurium was administered. TOF stimulation continued throughout the experiment in all dogs. The height of the first twitch (T1) (expressed as a fraction of T1 at tCAL) and train-of-four ratio (TOFR) were recorded until TOFR returned to ≥90%. Results In PG, T1 increased significantly (p = 0.0078) from a median of 102% (range, 95, 109) at baseline to 118% (100, 142) at 20 minutes. In PG, no difference was found between T1 at tCAL (immediately before atracurium administration) and T1 when neuromuscular transmission returned (p = 0.42). In the CG, T1 increased significantly between tCAL and the time neuromuscular transmission returned (p = 0.027). TOFR did not increase during twitch potentiation (all p = 0.32). Conclusions and clinical relevance T1 increased significantly during 20 minutes of uninterrupted TOF stimulation in the absence of NMB, establishing that twitch potentiation occurs in anesthetized dogs. With no time for potentiation, T1 increased during the course of recovery from NMB; this phenomenon introduces a bias in T1 measurements and could affect studies reporting potency and duration of NMB based on T1 or single twitches. TOFR was unaltered by potentiation emphasizing its clinical usefulness for excluding post-operative residual NMB." @default.
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- W1592369226 date "2011-07-01" @default.
- W1592369226 modified "2023-10-17" @default.
- W1592369226 title "Twitch potentiation: a potential source of error during neuromuscular monitoring with acceleromyography in anesthetized dogs" @default.
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- W1592369226 doi "https://doi.org/10.1111/j.1467-2995.2011.00620.x" @default.
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