A 55-year-old man with ARDS is receiving neuromuscular blockade with cisatracurium infusion. The ICU team monitors the depth of block using a peripher...

Question

A 55-year-old man with ARDS is receiving neuromuscular blockade with cisatracurium infusion. The ICU team monitors the depth of block using a peripheral nerve stimulator (train-of-four, TOF). The TOF count shows 0/4 twitches. What does this indicate?

Accepted Answer

Deep neuromuscular blockade - all four twitches are abolished, indicating >95% receptor blockade

Answer

No neuromuscular blockade - the nerve stimulator is malfunctioning

Answer

Partial recovery - ready for reversal

Answer

The patient requires a higher dose of cisatracurium

Answer

Train-of-four monitoring is unreliable in ICU

uk-fficm MCQ (SBA): Neuromuscular Blockade Monitoring

A 55-year-old man with ARDS is receiving neuromuscular blockade with cisatracurium infusion. The ICU team monitors the depth of block using a peripheral nerve stimulator (train-of-four, TOF). The TOF count shows 0/4 twitches. What does this indicate?