Kirkegaard-Nielsen H, Helbo-Hansen H S, Severinsen I K, Lindholm P, Bülow K
Department of Anaesthesia and Intensive Care, Odense University Hospital, Denmark.
Acta Anaesthesiol Scand. 1996 Jul;40(6):719-23. doi: 10.1111/j.1399-6576.1996.tb04517.x.
Double-burst stimulation (DBS) it a relatively new nerve stimulation mode introduced for improved manual detection of residual neuromuscular blockade. Previous studies have shown that DBS3,3 50/50 (3 stimuli at 50 Hz followed 0.75 seconds later by 3 stimuli at 50 Hz) can detect deeper degrees of neuromuscular blockade than train-of-four (TOF) stimulation.
The aim of the present study was to examine if DBS3,3 80/40 (3 stimuli at 80 Hz followed 0.750 s later by 3 stimuli at 40 Hz) can detect even deeper degrees of neuromuscular blockade than DBS3,3 50/50 and to determine the time lapse from reappearance of response to each of the two DBS modes until reappearance of response to the TOF mode of nerve stimulation.
The study comprised 20 women undergoing gynaecological surgery and anaesthetised with fentanyl, thiopentone, halothane, and nitrous oxide. Neuromuscular transmission was monitored by using mechanomyography and stimulation of the ulnar nerve. Atracurium was used for neuromuscular blockade.
Elapsed time from reappearance of response to DBS3,3 80/40 and DBS3,3 50/50 to reappearance of response to TOF stimulation was 459 +/- 196 (mean +/- SD) and 360 +/- 150 seconds, respectively, (P < 0.05).
DBS3,3 80/40 is capable of detecting deeper degrees of blockade than DBS3,3 50/50, which again is capable of detecting deeper degrees of blockade than TOF.
双爆发刺激（DBS）是一种相对较新的神经刺激模式，引入该模式是为了改善对残余神经肌肉阻滞的人工检测。先前的研究表明，DBS3,3 50/50（50赫兹下3次刺激，0.75秒后接着50赫兹下3次刺激）比四个成串刺激（TOF）能检测到更深程度的神经肌肉阻滞。
本研究的目的是检验DBS3,3 80/40（80赫兹下3次刺激，0.750秒后接着40赫兹下3次刺激）是否比DBS3,3 50/50能检测到更深程度的神经肌肉阻滞，并确定从两种DBS模式中每种模式的反应重新出现到神经刺激的TOF模式反应重新出现的时间间隔。
该研究包括20名接受妇科手术并使用芬太尼、硫喷妥钠、氟烷和一氧化二氮麻醉的女性。通过使用肌机械图和刺激尺神经来监测神经肌肉传递。使用阿曲库铵进行神经肌肉阻滞。
从DBS3,3 80/40和DBS3,3 50/50的反应重新出现到TOF刺激反应重新出现的 elapsed time分别为459±196（平均值±标准差）和360±150秒，（P<0.05）。
DBS3,3 80/40比DBS3,3 50/50能够检测到更深程度的阻滞，而DBS3,3 50/50又比TOF能够检测到更深程度的阻滞。 （注：原文中“elapsed time”未翻译完整，应是“间隔时间”之类更准确的表述，但按要求不添加解释，保留原文形式）
