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Nerve stimulation at 0.15 Hz when compared to 0.1 Hz speeds the onset of action of cisatracurium and rocuronium
Author(s) -
Eikermann M.,
Peters J.
Publication year - 2000
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1034/j.1399-6576.2000.440207.x
Subject(s) - rocuronium , medicine , stimulation , ulnar nerve , neuromuscular monitoring , rocuronium bromide , anesthesia , adductor pollicis muscle , compound muscle action potential , neuromuscular transmission , neuromuscular blockade , electrophysiology , surgery , propofol , elbow
Background: Onset time of specific non‐depolarizing muscle relaxants (NDMR), as reported in the literature, varies widely. To test the suggestion of a consensus panel (Copenhagen Consensus Conference 1996) that onset time in muscle relaxant studies depends on stimulation frequency, even in the low frequency range, we examined the onset time of cisatracurium and rocuronium by parallel ulnar nerve stimulation in both upper extremities at 0.1 Hz and 0.15 Hz. Methods: Thirty patients (ASA class I and II) were included. Onset of action following the administration of 2×ED90 of cisatracurium (0.092 mg · kg −1 ) or rocuronium (0.74 mg · kg −1 ) was measured by quantifying the evoked response of the adductor pollicis muscles using mechanomyography. Single twitch stimulations were applied simultaneously to the ulnar nerves of both forearms using a 0.1 Hz and 0.15 Hz stimulation frequency, respectively. Results: Both relaxants showed a significantly ( P <0.01) shorter onset time with 0.15 Hz compared to 0.1 Hz stimulation (cisatracurium: 186±50 s vs. 233±59 s, rocuronium: 73±14 s vs. 99±23 s; x?±SD). Conclusions: Onset time of NDMR depends on the stimulation frequency, even in the low frequency range. When comparing onset studies, the reader must also compare the stimulation rates used by the investigators. We recommend the use of 0.1 Hz single twitch nerve stimulation frequency as the standard for studies of onset profile of NDMR.