TOF ratio: onset versus spontaneous recovery

• The train of four (TOF) ratios can be demonstrated to differ during onset and offset of NDMR effects

• These are scientific measurements, dependent on transducer printouts and of limited clinical significance

Typical clinical TOF responses• Atracurium blockade: Note differences in TOF

ratio at onset and recovery, with greater difference (ratio) during recovery. Note:no train of 4 ratio at onset (arrow)

Acta Anaesthesiol Scand 2011; 55: 368–370

Neostigmine recovery and TOF ratioNeostigmine recovery and TOF ratio

Sugammadex recovery and Sugammadex recovery and TOF ratioTOF ratio