“Train of four” is associated with Weaning of ventilation

Question 20

“Train of four” is associated with

a.       Mechanical ventilation

b.      Muscle relaxants

c.       Weaning of ventilation

d.      None of the above

Answer

b. Muscle relaxants

Reference

Katsung 9^th Edition Page 435

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Katsung

Discussion

Assessment of Neuromuscular Transmission

Monitoring the effect of muscle relaxants during surgery (and recovery following the uise of cholinesterase inhibitors) typically involves the use of a device that produces transdermal electrical stimulation of one of the peripheral nerves to the hand and recording of the evoked contractions.

Explanation

Train of Four is A method for measuring magnitude and type of neuromuscular blockade, based upon the ratio of the amplitude of the fourth evoked mechanical response to the first one, when four supramaximal 2-Hz electrical currents are applied for 2 seconds to a peripheral motor nerve.

Comments

The three most commonly used patterns include

1. Single twitch stimulation
2. Train of four (TOF) Stimulation
3. Tetanic Stimulation

Tips

Two newer modalities are available to monitor neuromuscular transmission : double burst stimulation and post titanic count