By Bahaa Ewees Professor of anaesthesia and intensive care medicine.

Post on 18-Dec-2015

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Transcript of By Bahaa Ewees Professor of anaesthesia and intensive care medicine.

ByBahaa EweesProfessor of anaesthesia and intensive care medicine

* Why?

* How?

* Where?

A.Monitoring the onset time of action

B.Monitoring the duration of action

C.Monitoring of recovery

Methods

1.Electrical EMG TOF (?)

2.Mechanical3.Acceleration

T1, T2, T3, T4 … Complete Relaxation

Time T1 0 – 9 %

Muscle Relaxant of Different Duration Time of Action (HOW?)

T1 9 %

T1 25 %

T1 3 % (???) just reappearance of T1

Recovery

Tetanic Stimulation Post Tetanic Count Post Tetanic Facilitation Post Tetanic TOF Double Burst Stimulation

(DBS) DBS D2B2S

D3B3S

Acceleromyography

WHERE?

Ulnar N.

Facial N.

Common Peroneal N.

Adductor Pollicis (WHY?)

When To Give Reversal??

Half-reverse and Full reverse What is the meaning??

1st Dose followed by 2nd Dose (3 min. in between)

Conclusion

TR equals T4/T1 is the conclusion in recovery TR 75 % TR 85 % TR 98 %

* Why?

* How?

* Where?

A.Monitoring the onset time of action

B.Monitoring the duration of action

C.Monitoring of recovery

Thank You!!!