Canadian Journal of Anaesthesia

, Volume 43, Issue 4, pp 362–367 | Cite as

Recovery of post-tetanic and train-of-four responses at the first dorsal interosseous and adductor pollicis muscles in patients receiving vecuronium

  • Yuhji Saitoh
  • Hiroyoshi Tanaka
  • Hidenori Toyooka
  • Keisuke Amaha
Reports of Investigation



To compare recovery of accelographical responses to post-tetanic twitch (PTT) and train-of-four (TOF) stimuli obtained at the first dorsal interosseous muscle (DI) with those at the adductor pollicis muscle (AP) after administration of vecuronium 70 μg · kg−1.


Sixty adult patients were randomly assigned to one of four groups: PTT-DI (n = 15), PTT-AP (n = 15), TOF-DI (n = 15), or TOF-AP (n = 15) group. In PTT-DI and PTT-AP groups, responses to PTT were measured accelographically at the DI and at the AP, respectively. In TOF-DI and TOF-AP groups, responses to TOF were measured at the DI and at the AP, respectively.


The T1/T0 (T0 = control) was greater in the TOF-DI than in TOF-AP group throughout recovery (P < 0.05), and the T4/T1 was greater in the TOF-DI than in TOF-AP group during the 30–40 min after vecuronium injection (P < 0.05). Time to the return of the first response to PTT (post-tetanic count1, PTC1) was less in the PTT-DI than in the PTT-AP group (17.7 ± 4.2 vs 21.7 ± 5.6 min, mean ± SD, P = 0.0341). The post-tetanic count PTC (number of single twitch stimuli in response to PTT) was greater in the PTT-DI than in the PTT-AP group during the 10–30 min after vecuronium (P < 0.05). Time to the return of T1 was less in the TOF-DI than in the TOF-AP group (23.1 ± 6.0 vs 27.6 ± 4.9 min, P = 0.0334).


Recovery of responses to PTT and TOF stimuli occurred earlier at the DI than at the AP.

Key words

monitoring: post-tetanic twitch, train-of-four muscle: first dorsal interosseous muscle, adductor pollicis muscle neuromuscular relaxants: vecuronium 



Comparer la récupération des réponses accélerographiques du twitch post-tétanique (PTT) et du train-de-quatre (TOF) mesurées au niveau du premier muscle interosseux dorsal (DI) à celles du muscle adducteur du pouce (AP) après l’administration de vécuronium 70 μg · kg−1.


Soixante patients d’âge adulte ont été répartis aléatoirement à un de quatre groupes: PTT-DI (n = 15), PTT-AP (n = 15), TOF-DI (n = 15) et TOF-AP (n = 15). Dans les groupes PTT-DI et PTT-AP, les réponses au PTT ont été mesurées par accélérographie respectivement au DI et à l’AP. Dans les groupes TOF-DI et TOF-AP, les réponses au TOF ont été mesurées respectivement au DI et à l’AP.


Le T1/T0 (T0 = valeur de contrôle) a été plus élevé dans le groupe TOF-DI que dans le groupe TOF-AP pendant la récupération (P < 0,05) et le T4/T1 dans le groupe TOF-DI a été plus élevé que dans le groupe TOF-AP pendant les 30–40 min après l’injection du vécuronium (P < 0,05). Le délai de retour de la première réponse du PTT (le compte post-tétanique1, PTC1 (était plus court dans le groupe PTT-DI que dans le groupe PTT-AP (17,7 ± 4,2 vs 21,7 ± 5,6 min, moyenne ± ET, P = 0,0341). Le compte post-tétanique (le décompte des twitchs isolés en réponse au PTT) du groupe PTT-DI a été plus élevé que dans le groupe PTT-AP pendant les 10–30 min qui ont suivi le vécuronium (P < 0,05). Le délai de retour de T1 dans le groupe TOF-DI a été plus court dans le groupe TOF-DI que dans le groupe TOF-AP (23,1 ± 6,0 vs 27,6 ± 4,9 min, P = 0,0334).


La récupération des réponses aux stimuli du PTT et du TOF est survenue plus rapidement au DI qu ’à l’AP.


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Copyright information

© Canadian Anesthesiologists 1996

Authors and Affiliations

  • Yuhji Saitoh
    • 1
  • Hiroyoshi Tanaka
    • 1
    • 2
  • Hidenori Toyooka
    • 1
  • Keisuke Amaha
    • 1
  1. 1.Department of Anesthesiology and Critical Care Medicine, Faculty of MedicineTokyo Medical and Dental UniversityTokyoJapan
  2. 2.Department of AnesthesiologyToride Kyodo General HospitalIbarakiJapan

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