Clinical assessment of the muscular response to tetanic nerve stimulation.

The study was undertaken in order to determine clinical tactile evaluation of tetanic nerve stimulation (50 Hz, 5 sec) as a means of detecting fade and possible residual curarization. Forty-four patients were studied and 128 clinical evaluations by eight different observers were performed at various levels of neuromuscular blockade. Tetanic fade was detected reliably by clinical evaluation only when high degrees of fade (tetanic fade ratio of 0.3 or less) were detected with a force-displacement transducer. We conclude that the clinical tactile assessment of the response to tetanic stimulation is not accurate except at very high degrees of fade and that its usefulness in monitoring neuromuscular recovery is doubtful.