Value of the electromyographic monitoring in the revertion of the muscle relaxants

Comparative EMG study of the revertion of the neuromuscular function after the use of three kinds of non-depolarizing muscle relaxants in sixty patients which were subclassified into three groups , of twenty patients were every one , for had been elective cholecystectomy. Indicating the use of anticholinesterasic drug ( neostigmine) which must be used when the patients had been retired of equal or more than 50%of the control twitch height and would not be doing extubation till the height would be reaching more than 70% of the control. The use of anticholinesterases to reverse residual neuromuscular block is efficacious only if recovery is already established. It was originally advised that at least the second twitch (T2) of the train-of-four response should be detectable before neostigmine is administered [1]. Of aiming for preventing the incomplete revertion with the increasing mortality and morbidity[2]. and for preventing residual respiratory paralysis in the recovery wards.Even though neuromuscular blocking agents are an essential part of balanced anesthesia and the risks of residual paralysis are well documented, many anesthetists seldomly monitor neuromuscular block. Classical reversal agent neostigmine is unable to antagonise a deep neuromuscular block and is rather slow to antagonise even a moderate block [3]. Some always use a TOFratio monitor if available - the goal is a ratio of 0.9 - if i have a simple TOFcount machine - I wait for 4 responses and then antigonize [4]