Train of Four ratio

Рет қаралды 100,273

Michael Bentley

Күн бұрын

Train of four ratio

Пікірлер: 60

@AjaySensei Жыл бұрын

This video is still helping students 8 years later. Thank you!

@rashmii.k1887 9 жыл бұрын

The TOF explained clearly and actually got a hang of the same for the first time today, inspite of reading it a couple of times before. Thanks a ton and God bless! BTW I am an Anesthesia trainee. RIK

@marlened2681 6 жыл бұрын

You explain it beautifully. I am not an anesthesiologist nor anesthetist. I have been employed as a psychiatric physician assistant. I was doing some research on anesthetics and neuromuscular blockade agents, this evening, and came across Train Of Four ratios. Your video explained it very succinctly and clearly. Thank you for the few-minute education lecture.

@krushingkobra 6 жыл бұрын

Clearest explanation I've ever encountered! Thanks!

@danielcastilo1840 3 жыл бұрын

Thank you Dr., excellent and highly practical video .God bless

@BlaackAnchor 5 жыл бұрын

You are amazing sir! Well understood.

@khushboopanwala688 2 жыл бұрын

marvellous explanation with simple graphical presntation. keep up doing such nice work !!! it is great to dedicate your self to your speciality.

@nehemiahwilson6864 2 жыл бұрын

Very intelligently explained. Thank you!

@VictorySpecification 4 жыл бұрын

Excellent video. Thank you!

@HIBAVentila 6 жыл бұрын

Very interesting topic!

@beatrizellerbarbosa7778 3 жыл бұрын

Great explanation! Thank you!

@shifaoosman3822 2 жыл бұрын

Thank you so much! This video made it so clear!

@drvivekvirsingh2586 5 жыл бұрын

Thank you so much. Explaned clearly😊

@emilyasselin1 8 жыл бұрын

Thank you, awesome vid

@Kdyuk 3 ай бұрын

brilliantly explained . thank you.

@dennerdovandojr.8878 4 жыл бұрын

Great vid! Thanks

@framma9968 8 ай бұрын

Excellent explanation ❤❤

@nivedithashatheeash3492 3 жыл бұрын

Very helpful, thank you!!

@MrNakedWizard 9 жыл бұрын

Thank you very much!

@vannessameow4261 2 жыл бұрын

Thanks. It was very useful. For the 1st time i got the tof🤗

@b.a7929 9 жыл бұрын

I am kind of confused on the last point Can u please explain how phase two succinylcholine appear to fade starting from 100%, isn't it like phase two is paralysis where the receptor of the end plate are resistant to stimulation from Ach. As I understood paralysis will yield no twitch so it's weird that we have 4 twitches and even a 100% twitch Last Q: what train of four count ? Thank you very much very informative explanation

@scarlettnakajima8643 7 жыл бұрын

Thank you. Good review

@elizabethbennett5706 Жыл бұрын

Thank you!!! So helpful!

@Hopeexists2024 7 жыл бұрын

excellent video

@sandyp3598 7 жыл бұрын

THANK YOU!!! I finally understand it ❤❤❤❤❤❤❤🎓🎓🎓🎓🎓💉💉💉💉💉

@alexkrmdas3430 6 жыл бұрын

helpful only if you only wanna know how to distuingish between depol and non-depol;NOT helpful if you want to understand the underlying mechanism behind the ratios.

@MichaelBentleyphd 6 жыл бұрын

alex krmdas I did a vid on that too

@lilturbo31 Жыл бұрын

How does this translate to a clinical setting? I understand the concept behind TOF, fade, and TOF ratio. However, how would you be able to assign an actual percentage to your twitches? I feel like this would be very subjective and not necessarily reliable. Is this correct?

@CollinScottTibbitts 4 ай бұрын

You're correct! TOF ratio is an objective measurement with specialized equipment. This is called quantitative assessment of the NMB, whereas twitch count is qualitative and subjective

@docash6286 2 жыл бұрын

Thanks!

@IdeaMusicKen 2 жыл бұрын

Excellent vidoe

@mkmd9762 9 жыл бұрын

Great

@abhisekrocks5564 8 жыл бұрын

i wanna ask... why the response for succinylcholine is 50 percent of normal..? and why it doesnt show fade during phase 1

@annanelson9072 6 жыл бұрын

How do you measure the Magnitude, is it a generalized guess? So when we're talking about TOFR being

@annanelson9072 6 жыл бұрын

How can they be certain its .9, or .7.. Would everyone get the same TOFR or could it differ between providers?

@daihongbograce 3 жыл бұрын

best explanation ever

@t-thevil2256 2 жыл бұрын

Thank you so much si!!

@nidaahmad7526 Жыл бұрын

👍

@shruthikarthikeyan1227 3 жыл бұрын

❤️

@dr.shrankhlapaliwal4325 7 жыл бұрын

Finally i got it...but why does this happen with phase 1 that no fade is there?

@gyehud 6 жыл бұрын

with succinylcholine - you get depolarization/activation at a bunch of neuromuscular receptors. These receptors then remain "blocked"/unresponsive to acetylcholine for a certain amount of time. When you then do a TOF - what happens is that you stimulate release of acetylcholine into the NMJ and the receptors that aren't "blocked" will respond. They will respond every time. And so there is no FADE but the overall amplitude is lower because not all of the receptors are available to respond. Now with Rocuronium for instance - you have a non-depolarizing agent which acts like a competitive inhibitor at the acetylcholine receptor. So when you start your TOF - what happens is that first you get a release of acetylcholine into the NMJ and this release is strong enough to stimulate all receptors (or most), but with each subsequent stimulation, you get less and less acetylcholine released into the NMJ and because of the competitive inhibitor by rocuronium, less receptors get "activated" because now the competition is starting to "win more". Note: with Succynilcholine you also get less and less acetylcholine released into the NMJ, but there is no competition to the free receptors so they all still get stimulated (i.e there is enough acetylcholine still to activate them all). Hope this made sense.

@dr.shrankhlapaliwal4325 6 жыл бұрын

Thanks a ton for this!!

@ankitadahiya3415 2 жыл бұрын

Very helpful...

@nepaliman5716 3 жыл бұрын

Thank you sir.

@thehandlez 3 жыл бұрын

UW brought me here lol.

@ahmednashin456 Жыл бұрын

Thank u sir

@anupriya5569 4 жыл бұрын

Sir what s the criteria for adequate reversal

@pshreya15 4 жыл бұрын

Anu Priya Follows commands Swallowing reflex present Able to lift head for more than 5 sec -> BEST CLINICAL SIGN Tidal vol > 6ml/kg Vital capacity > 10ml/kg TOF ratio of T4/T1 is > 0.9 -> BEST SIGN OVERALL Dead space/tidal vol < 0.6

@abhisekrocks5564 8 жыл бұрын

i want to ask... why the response for succinylcholine is 50 percent of normal..? and why it doesnt show fade during phase 1