A Prospective Randomized Comparison of Train-of-Four Monitoring and Clinical Assessment During Continuous ICU Cisatracurium Paralysis

摘要: Study purpose: Train-of-four (TOF) monitoring is often recommended during the continuous use of neuromuscular blockade (NMB) [paralysis] in ICU. Prior study results are conflicting regarding benefits TOF monitoring. Design: Thirty patients medical ICU were randomized to (n = 16) or clinical assessment 14) cisatracurium infusion. was done at least every 4 h, with goal being maintenance one two twitches. Statistical analysis performed by two-tailed, unpaired t test (with Bonferroni correction for multiple comparisons), χ 2 , and Fisher exact test, p Results: The mean recovery time after cessation paralytics no different between (45 ± 7 min vs 38 10 min, respectively [mean SEM]). No differences noted APACHE (acute physiology chronic health evaluation) II entry scores, glomerular filtration rates, corticosteroids. significant total paralysis (4,118 1,012 3,188 705 respectively), dose (920 325 mg 715 167 mg), dosage (2.3 0.2 μg/kg/min 2.9 μg/kg/min). Conclusions: does not lead improved lower dosing compared assessment. We conclude that unnecessary, careful titration blocking agent alone sufficient undergoing NMB.