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Orbicularis Oculi Muscle as Reliable Monitor of Neuromuscular Block Onset and Recovery in Patients under General Anesthesia who are induced with Atracurium and Reversed with Neostigmine.


Odyss Gladney A. Sapalleda-Obuyes,
Harold Joseph C. Lumang

Related Institution

Department of Anesthesiology - Northern Mindanao Medical Center - Department of Health

Publication Information

Publication Type
Publication Sub Type
Journal Article, Original
Northern Mindanao Medical Journal
Biennial (every 2 years)
Publication Date
July-December 2017


The orbicularis oculi (OO) muscle has been recommended for neuromuscular monitoring when the adductor pollicis muscle is not accessible. This study aims to determine if orbicularis muscle could be a reliable measurement of onset and recovery of neuromuscular block compared with adductor pollicis among patients under general anesthesia. 

This study included ten patients (n=10) who underwent general anesthesia induced with Atracurium and reversed with Neostigmine. Time of onset of complete neuromuscular block, as well as recovery from block through determination of Train of Four >70% and >90% of adductor pollicis and orbicularis oculi were determined.

Time of onset of complete neuromuscular block was significantly shorter at the OO than at the AP (P 0.0105). Recovery from neuromuscular block at TOF >70% and TOF >90% were significantly earlier at the OO than at the AP (P 0.0017< 0.05 and P 0.0027< 0.05, respectively).

The orbicularis is the first to be blocked after neuromuscular blockade with Atracurium and also recovered earlier than the adductor pollicis after reversal with Neostigmine. 

Physical Location

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Professional Education and Training Office, Northern Mindanao Medical Center tro_nmmc@yahoo.com Fulltext Print Format

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