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
@AjaySensei2 жыл бұрын
This video is still helping students 8 years later. Thank you!
@marlened26816 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.
@danielcastilo18403 жыл бұрын
Thank you Dr., excellent and highly practical video .God bless
@khushboopanwala6883 жыл бұрын
marvellous explanation with simple graphical presntation. keep up doing such nice work !!! it is great to dedicate your self to your speciality.
Thanks. It was very useful. For the 1st time i got the tof🤗
@lilturbo312 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?
@CollinScottTibbitts9 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
@VictorySpecification4 жыл бұрын
Excellent video. Thank you!
@elizabethbennett5706 Жыл бұрын
Thank you!!! So helpful!
@docash62863 жыл бұрын
Thanks!
@shifaoosman38223 жыл бұрын
Thank you so much! This video made it so clear!
@beatrizellerbarbosa77783 жыл бұрын
Great explanation! Thank you!
@alexkrmdas34307 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.
@MichaelBentleyphd7 жыл бұрын
alex krmdas I did a vid on that too
@Hopeexists20247 жыл бұрын
excellent video
@daihongbograce3 жыл бұрын
best explanation ever
@BlaackAnchor6 жыл бұрын
You are amazing sir! Well understood.
@dennerdovandojr.88784 жыл бұрын
Great vid! Thanks
@HIBAVentila6 жыл бұрын
Very interesting topic!
@ahmednashin456 Жыл бұрын
Thank u sir
@t-thevil22563 жыл бұрын
Thank you so much si!!
@ankitadahiya34153 жыл бұрын
Very helpful...
@nivedithashatheeash34924 жыл бұрын
Very helpful, thank you!!
@abhisekrocks55648 жыл бұрын
i wanna ask... why the response for succinylcholine is 50 percent of normal..? and why it doesnt show fade during phase 1
@Alquran_life2 жыл бұрын
Thank u sooooo much
@dr.shrankhlapaliwal43257 жыл бұрын
Finally i got it...but why does this happen with phase 1 that no fade is there?
@gyehud7 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.shrankhlapaliwal43256 жыл бұрын
Thanks a ton for this!!
@b.a79299 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
@nidaahmad75262 жыл бұрын
👍
@riyazsheikh19123 ай бұрын
❤
@drvivekvirsingh25865 жыл бұрын
Thank you so much. Explaned clearly😊
@MrNakedWizard9 жыл бұрын
Thank you very much!
@anupriya55695 жыл бұрын
Sir what s the criteria for adequate reversal
@pshreya155 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
@annanelson90727 жыл бұрын
How do you measure the Magnitude, is it a generalized guess? So when we're talking about TOFR being
@annanelson90727 жыл бұрын
How can they be certain its .9, or .7.. Would everyone get the same TOFR or could it differ between providers?
@sandyp35987 жыл бұрын
THANK YOU!!! I finally understand it ❤❤❤❤❤❤❤🎓🎓🎓🎓🎓💉💉💉💉💉
@emilyasselin19 жыл бұрын
Thank you, awesome vid
@mkmd97629 жыл бұрын
Great
@scarlettnakajima86438 жыл бұрын
Thank you. Good review
@DrRandeerChemistry4 жыл бұрын
thanks
@shruthikarthikeyan12273 жыл бұрын
❤️
@nepaliman57164 жыл бұрын
Thank you sir.
@thehandlez3 жыл бұрын
UW brought me here lol.
@cattymed44194 жыл бұрын
thank u
@ddas79742 жыл бұрын
Why tof not reduced in Sch
@MoHadeg9 жыл бұрын
Thank you
@81470616897 жыл бұрын
Thank u
@keerthanareddy22254 жыл бұрын
But wat is d concept behind it🤦
@cattymed44194 жыл бұрын
understand the mechanism of depolarising and non depolarising blockadse you will understan it fast
@atifjaved57514 жыл бұрын
Great
@abhisekrocks55648 жыл бұрын
i wanna ask... why the response for succinylcholine is 50 percent of normal..? and why it doesnt show fade during phase 1
@anupriya55695 жыл бұрын
Thank u
@abhisekrocks55648 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