Abstract
A new pattern of nerve stimulation-double burst stimulation (DBS)-to detect residual neuromuscular blockade using only with peripheral nerve stimulator was presented. The DBS consists of two short lasting, 50Hz tetanic stimuli or bursts separated by a 750msec. interval. The response to this pattern of stimulation is two single separated muscle contractions of which the second is less than the first during non-depolarizing neuromuscular blockade. The ability to identify fade manually at different train-of-four (TOF) ratios was compared in three DBS modes (DBS2.2, DBS3.2 and DBS3.3) in which different numbers of impulses in the individual bursts were combined. The DBS with three and two impulses in each burst (DBS3.2) was considered to be the most suitable mode for clinical practice especially when residual anesthesia remained.
