Brand J B, Cullen D J, Wilson N E, Ali H H
Anesth Analg. 1977 Jan-Feb;56(1):55-8. doi: 10.1213/00000539-197701000-00014.
The effects of nondepolarizing muscle relaxants were allowed to wear off spontaneously in 10 ASA class III and IV patients following major surgery. Neuromuscular and respiratory function were followed by clinical testing and by evoked muscle responses using a train of 4 (TOF) supramaximal stimuli. At a TOF of 70 percent (range 62 to 78%), all patients sustained eye-opening, hand-grasp, and tongue-protrusion, while 9/10 sustained head-lift. Vital capacity (VC) averaged 17 ml/kg when the TOF reached 70 percent. The increase in VC correlated with the increase in TOF (r = 0.88). There was no correlation between inspiratory force (IF) and TOF, but all patients achieved an IF equal to or greater than -22 cm H2O at 70 percent. Thus, TOF correlates well with clinical signs of neuromuscular and respiratory recovery in this group of patients and complements earlier studies in healthy anesthetized patients and nonmedicated volunteers.
10例ASA III级和IV级的大手术患者，非去极化肌松药的作用任其自行消退。通过临床测试以及使用四个成串（TOF）超强刺激诱发肌肉反应来监测神经肌肉和呼吸功能。当TOF为70%（范围62%至78%）时，所有患者均可维持睁眼、握力和伸舌动作，而10例中有9例可维持抬头动作。当TOF达到70%时，肺活量（VC）平均为17 ml/kg。VC的增加与TOF的增加相关（r = 0.88）。吸气力（IF）与TOF之间无相关性，但所有患者在TOF为70%时吸气力均达到或大于-22 cm H2O。因此，在这组患者中，TOF与神经肌肉和呼吸恢复的临床体征相关性良好，补充了早期对健康麻醉患者和未用药志愿者的研究。
