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Neural nets and prediction of the recovery rate from neuromuscular block

  • O. A. P. Santanen (a1), N. Svartling (a2), J. Haasio (a2) and M. P. J. Paloheimo (a1)


Background and objective: The aim was to train artificial neural nets to predict the recovery of a neuromuscular block during general anaesthesia. It was assumed that the initial/early neuromuscular recovery data with the simultaneously measured physical variables as inputs into a well-trained back-propagation neural net would enable the net to predict a rough estimate of the remaining recovery time.

Methods: Spontaneous recovery from neuromuscular block (electrically evoked electromyographic train-of-four responses) were recorded with the following variables known to affect the block: multiple minimum alveolar concentration, end-tidal CO2 concentration, and peripheral and central temperature.

Results: The mean prediction errors, mean absolute prediction errors, root-mean-squared prediction errors and correlation coefficients of all the nets were significantly better than those of average-based predictions used in the study. The root-mean-squared prediction error of the net – employing minimum alveolar concentrations from the whole recovery period (the recovery time from E2/E1 = 0.30 to E4/E1 = 0.75; E1 = first response of train-of-four, E2 = second response of train-of-four, etc.) – were significantly smaller than those of other nets, or the same net employing minimum alveolar concentrations only from the initial recovery period (from E2/E1 = 0.30 to E4/E1 = 0.25).

Conclusions: Neural nets could predict individual recovery times from the neuromuscular block significantly better than the average-based method used here, which was supposed to be more accurate than guesses by any clinician. The minimum alveolar concentration was the only monitored variable that influenced the recovery rate, but it did not aid neural net prediction.

Corresponding author
Correspondence to: Markku Paloheimo, Department of Anaesthesia and Intensive Care Medicine, Eye-ENT Clinic, Helsinki University Central Hospital, FIN-00029 HUS, Finland. E-mail:; Tel: +35 8400424566
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KimWO, KilHK, KangJW, ParkHR. Prediction on lengths of stay in the postanesthesia care unit following general anesthesia: preliminary study of the neural network and logistic regression modelling.J Korean Med Sci2000; 15: 2530.

CarpenterRL, MulroyMF. Edrophonium antagonizes combined lidocaine–pancuronium and verapamil–pancuronium neuromuscular blockade in cats.Anesthesiology1986; 65: 506510.

DupuisJY, MartinR, TetraultJ-P. Atracurium and vecuronium interaction with gentamicin and tobramycin.Can J Anaesth1989; 36: 407411.

RuppSM, MillerRD, GencarelliPJ. Vecuronium-induced neuromuscular blockade during enflurane, isoflurane, and halothane anesthesia in humans.Anesthesiology1984; 60: 102105.

PittetJF, MelisA, RougeJC, et al. Effect of volatile anesthetics on vecuronium-induced neuromuscular blockade in children.Anesth Analg1990; 70: 248252.

VanlinthoutLE, BooijLH, van EgmondJ, RobertsonEN. Effect of isoflurane and sevoflurane on the magnitude and time course of neuromuscular block produced by vecuronium, pancuronium and atracurium [see comments].Br J Anaesth1996; 76: 389395.

ErikssonLI, StaunP, LennmarkenC. The influence of 0.5% isoflurane on a vecuronium-induced neuromuscular blockade.Acta Anaesth Scand1989; 33: 309312.

BuzelloW, SchluermannD, PollmaecherT, SpillnerG. Unequal effects of cardiopulmonary bypass-induced hypothermia on neuromuscular blockade from constant infusion of alcuronium, d-tubocurarine, pancuronium and vecuronium.Anesthesiology1987; 66: 842846.

ErikssonLI, Viby-MogensenJ, LennmarkenC. The effect of peripheral hypothermia on a vecuronium-induced neuromuscular block.Acta Anaesth Scand1991; 35: 387392.

FunkDI, CrulJF, PolFM. Effects of changes in acid–base balance on neuromuscular blockade produced by ORG-NC 45.Acta Anaesth Scand1980; 24: 119124.

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European Journal of Anaesthesiology
  • ISSN: 0265-0215
  • EISSN: 1365-2346
  • URL: /core/journals/european-journal-of-anaesthesiology
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