• Hisashi Hattori, Yuhji Saitoh, Hiroshi Nakajima, Norie Sanbe, Masahiko Akatu, and Masahiro Murakawa.
• Department of Anesthesiology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan. hattori@sb.dcns.ne.jp
• J Clin Anesth. 2005 Jun 1;17(4):276-80.

Study ObjectiveThe aim of this study is to investigate the probability of visual detection of fade in response to train-of-four (TOF) stimulation, double-burst stimulation3,3 (DBS(3,3)), or DBS(3,2) at the eyelid in comparison to that at the thumb.DesignThis is a randomized single-blinded study.SettingThe study took place at the University hospital.Patients And MeasurementsSixty adult patients underwent general anesthesia.Interventions And MeasurementsPatients were randomly divided into either the eyelid group (n = 30) or the thumb group (n = 30). In the eyelid group, at the varying degrees of neuromuscular block caused by vecuronium, TOF, DBS(3,3), or DBS(3,2) were given at the temporal branch of the facial nerve, and the probability of visual detection of fade in response to TOF, DBS(3,3), or DBS(3,2) was determined at the eyelid. Similarly, in the thumb group, the probability of visual detection of fade in response to TOF, DBS(3,3), or DBS(3,2) was examined at the thumb.Main ResultsWhen the true TOF ratios were 0 to 0.60, the probability of detection of TOF fade in the eyelid group was significantly lower than in the thumb group (P < .05). At the true TOF ratios of 0.31 to 0.70, the probability of visual detection of DBS(3,3) fade in the eyelid group was significantly less than in the thumb group (P < .05). When the true TOF ratios were 0.81 to 1.00, the probability of detection of DBS(3,2) fade in the eyelid group was significantly higher than in the thumb group (P < .05).ConclusionThe probability of visual detection of fade in response to TOF or DBS(3,3) is lower at the eyelid than the thumb. In contrast, DBS(3,2) fade tends to be seen more frequently at the eyelid than at the thumb.

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