Nerve stimulation at 0.15 Hz when compared to 0.1 Hz speeds the onset of action of cisatracurium and rocuronium

M. Eikermann, J. Peters

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

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 2xED90 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;x̄±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.

Original languageEnglish (US)
Pages (from-to)170-174
Number of pages5
JournalActa Anaesthesiologica Scandinavica
Volume44
Issue number2
DOIs
StatePublished - 2000
Externally publishedYes

Keywords

  • Cisatracurium
  • Monitoring
  • Nerve stimulation frequency
  • Neuromuscular block
  • Neuromuscular function
  • Onset of action
  • Rocuronium

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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