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Calculation of doses neuro-muscular blocking agents on the basis of their plasma concentration provides necessary level of a myoplegia and allows to assess of neuromuscular block along with TOF-monitoring use.
330 indications of TOF-Watch SX (Schering–Plough Corporation, USA) and corresponded for the given moment of time the calculated rocuronium plasma concetrations have been measured for research of dependence of change of neuromuscular blocking agent plasma concentration and indications TOF.
Spearman's rank correlation coefficient calculation is carried out. Statistically significant high correlation between TOF and Ñp (R = -0,87), TOF and Ce (R = -0,87) has been found out.
Conclusion: The received result shows possibility of use of the program TIVAManagerPro for the calculation of rocuronium plasma concentration based on PK/PD model developed by Wierda J.M. (1991). It allows to plan administration of muscle relaxants and to control level of neuromuscular blockade along with use TOF.
In the research it has been found that achievement of surgical level of myoplegia (TOF = 0%) is carried out by maintenance of rocuronium plasma concentration at level 1,38 (1,10 - 1,92) mcg/ml. Also it has been established that decrease in calculated rocuronium plasma concentration below 0,47 mcg/ml corresponded to values TOF > 80%.
Conclusion: Administration muscular relaxants according to their calculated plasma concentration provides not only necessary level myoplegia in the intraoperative period, but allows to provide control of restoration of neuromuscular function at an awakening stage.
Thus, use of calculated plasma concentration of muscular relaxants allows to exclude routine use of TOF-stimulation in the intraoperative period.


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