The effect of changes in arm temperature on neuromuscular monitoring in the presence of atracurium blockade.

This study was designed to investigate the relationship between arm temperature and the degree of blockade as monitored by peripheral nerve stimulation by a comparison of both arms of each patient; one exposed to the environment and the other wrapped to maintain its temperature. The decrease in the temperatures of the exposed arms were significantly more than the wrapped arms. A discrepancy was noted proportional to the temperature difference between the two arms, when the train-of-four counts were compared. A recommendation is made to maintain the temperature of the monitored arm above 32 degrees C.