In patients in whom response to peripheral nerve stimulation indicated residual neuromuscular block Train of Four Ratio <0.80, Train of Four stimulation was continued and response assessed every minute until Train of Four Ratio reached 0.80.
We found an incidence of 10% of residual neuromuscular block after the use of atracurium as assessed by Train of Four response, which is lower than incidence observed with pancuronium (40%).
In the patients who exhibited residual neuromuscular block, mean time to complete recovery i.e., Train of Four Ratio = 0.80 was 9.65 mins for group 'P' and 2.8 mins for group 'A'.
Butterlyl have mentioned that Post Anesthesia Care Unit length of stay was significantly longer in patients with Train of Four Ratio less than 0.9 (17) and also Murphy Glesn S et al have also concluded that incidence and severity of symptoms of muscle weakness were increased in Post Anesthesia Care Unit with a Train of Four less than 0.9 (18)
Clinical recovery and train of four ratio measured mechanically and electromyographically following atracurium.