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By Bahaa Ewees Professor of anaesthesia and intensive care medicine

By Bahaa Ewees Professor of anaesthesia and intensive care medicine

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Page 1: By Bahaa Ewees Professor of anaesthesia and intensive care medicine

ByBahaa EweesProfessor of anaesthesia and intensive care medicine

Page 2: By Bahaa Ewees Professor of anaesthesia and intensive care medicine

* Why?

* How?

* Where?

Page 3: By Bahaa Ewees Professor of anaesthesia and intensive care medicine

A.Monitoring the onset time of action

B.Monitoring the duration of action

C.Monitoring of recovery

Page 4: By Bahaa Ewees Professor of anaesthesia and intensive care medicine

Methods

1.Electrical EMG TOF (?)

2.Mechanical3.Acceleration

Page 5: By Bahaa Ewees Professor of anaesthesia and intensive care medicine
Page 6: By Bahaa Ewees Professor of anaesthesia and intensive care medicine

T1, T2, T3, T4 … Complete Relaxation

Time T1 0 – 9 %

Page 7: By Bahaa Ewees Professor of anaesthesia and intensive care medicine

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

Page 8: By Bahaa Ewees Professor of anaesthesia and intensive care medicine

T1 9 %

T1 25 %

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

Page 9: By Bahaa Ewees Professor of anaesthesia and intensive care medicine
Page 10: By Bahaa Ewees Professor of anaesthesia and intensive care medicine
Page 11: By Bahaa Ewees Professor of anaesthesia and intensive care medicine
Page 12: By Bahaa Ewees Professor of anaesthesia and intensive care medicine
Page 13: By Bahaa Ewees Professor of anaesthesia and intensive care medicine
Page 14: By Bahaa Ewees Professor of anaesthesia and intensive care medicine
Page 15: By Bahaa Ewees Professor of anaesthesia and intensive care medicine
Page 16: By Bahaa Ewees Professor of anaesthesia and intensive care medicine

Recovery

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

(DBS) DBS D2B2S

D3B3S

Page 17: By Bahaa Ewees Professor of anaesthesia and intensive care medicine

Acceleromyography

WHERE?

Page 18: By Bahaa Ewees Professor of anaesthesia and intensive care medicine

Ulnar N.

Facial N.

Common Peroneal N.

Page 19: By Bahaa Ewees Professor of anaesthesia and intensive care medicine

Adductor Pollicis (WHY?)

Page 20: By Bahaa Ewees Professor of anaesthesia and intensive care medicine

When To Give Reversal??

Page 21: By Bahaa Ewees Professor of anaesthesia and intensive care medicine

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

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

Page 22: By Bahaa Ewees Professor of anaesthesia and intensive care medicine

Conclusion

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

Page 23: By Bahaa Ewees Professor of anaesthesia and intensive care medicine

* Why?

* How?

* Where?

Page 24: By Bahaa Ewees Professor of anaesthesia and intensive care medicine

A.Monitoring the onset time of action

B.Monitoring the duration of action

C.Monitoring of recovery

Page 25: By Bahaa Ewees Professor of anaesthesia and intensive care medicine

Thank You!!!