Observation of Neuromuscular Block Clinical Trial
Current guidelines recommend monitoring of neuromuscular blockade at the adductor pollicis by
stimulation of the ulnar nerve at the wrist.
However, in certain situations (laparoscopic surgery, cranial surgery or surgical comfort,
arterial catheterization), it is impossible to access the patient's wrists, delaying
monitoring, antagonizing the neuromuscular block, the emergence from anesthesia and patient
extubation , leading in some cases to single injections lack of control of the reversal of
the patient.
To overcome these technical difficulties, a group nerve / muscle looks interesting and often
easily accessible to the anesthesiologist.
The stimulation of the posterior tibial nerve can observe a response to the flexor hallucis
brevis muscle and allows quick access to monitoring the reversal before the end of the
intervention.
The primary outcome was to compare the speed of recovery from neuromuscular block flexor
hallux versus that of the adductor pollicis.
The secondary objective was to compare the speed of installation of deep neuromuscular block
flexor hallucis versus that of the adductor pollicis.
This is a prospective, exploratory, uncontrolled, single-center for routine care.
Are included all aged patients over 18 years, ASA I or II, without guardianship, having no
known allergy to Atracurium, without neuromyopathy known, emergency surgery or full stomach,
predictable difficult intubation .
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