Variability in assessment of neuromuscular blockade

This study of 15 patients shows that, using the train-of-four technique, assessment of neuromuscular blockade with d-tubocurarine and succinylcholine varies depending on the site and type of twitch-monitoring electrodes. Compared with standard ulnar needle electrodes, ulnar surface electrodes tend to overestimate, and periorbital surface electrodes to underestimate, the neuromuscular block. Knowledge of the relative sensitivities of these three methods may foster accurate monitoring of neuromuscular blockade, regardless of the method employed.