I know that the exact neuromuscular monitoring is difficult in children because of immaturity of NMJ, high failure rate of calibration and unstable responses on monitoring etc. I wonder the differences in operation methods and devices of the monitoring bewteen adults and children, and so especially what kind of monitoring (AMG, MMG, KMG or EMG) is more effective and proper for children aged from 2 to 10 years.
I suggest you contact Barbara Brandom MD. She the has extensive experience you request.
Dept. Anesthesiology
Children's Hospital
1 Childen's Place
3705 5th Ave at DeSoto Street
Pittsburgh PA 15213
Ask the surgeon! I believe treating the train of four etc to be responsible for more post operative re-curarisations then any other factor. If the surgeon is not struggling then the patient is adequately blocked. Similarly, gauging the need for reversal based on the nerve stimulator is not sensible. The nerve stimulator tells you that at that moment of time, at that respiratory rate and tidal volume and at that PCO2 and pH, the patient is likely to able to breath on their own. Now take them to recovery, administer adequate analgesia (i.e. enough to right shift their CO2 response curve) and see the effect of the increased CO2, reduced pH and dissociation of muscle relaxant molecule into its active form. Suddenly self ventilation is inadequate, more CO2 accumulation, lower pH and more active relaxant and all because the anaesthetist has slavishly treated to instrument and not the patient. :0
- Badges
- Science topic
- Similar topics
- Correction