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train-of-four

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train-of-four,
a test for measuring the level of neuromuscular blockade. Four consecutive stimuli are delivered along the path of a nerve, and the response of the muscle is measured in order to evaluate stimuli that are blocked versus those that are delivered. Four equal muscle contractions will result if there is no neuromuscular blockade, but, if nondepolarizing blockade is present, there will be a loss of twitch height and number, which will indicate the degree of blockade. This test is commonly used in intensive care units.


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