Muscle relaxants: double burst stimulation: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Muscle relaxants: double burst stimulation

Sample item

At the end of surgery, the anaesthetist cannot reliably judge fade on the train-of-four by touch as the ratio approaches 0.5. Which stimulation pattern makes fade easier to feel at this stage?

ASingle twitchBPost-tetanic countCDouble burst stimulationDTrain-of-four count

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Double burst stimulation

Double burst stimulation delivers two short bursts of three impulses, and fade between the bursts can be felt at a ratio of up to about 0.6, better than train-of-four. Post-tetanic count assesses very deep block, and a single twitch does not show fade at all.

Option by option

A. Single twitch
A single twitch cannot show fade because it compares with a control only.
B. Post-tetanic count
Post-tetanic count is used for intense block with no twitches.
C. Double burst stimulation (correct)
Correct. The two bursts make residual fade easier to detect by touch.
D. Train-of-four count
Train-of-four count assesses deeper block and is what is already limited here.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is C, Double burst stimulation. Double burst stimulation delivers two short bursts of three impulses, and fade between the bursts can be felt at a ratio of up to about 0.

Why is "Single twitch" not the answer?

A single twitch cannot show fade because it compares with a control only.

Why is "Post-tetanic count" not the answer?

Post-tetanic count is used for intense block with no twitches.

Why is "Train-of-four count" not the answer?

Train-of-four count assesses deeper block and is what is already limited here.

What concept does this question test?

It tests Muscle relaxants: double burst stimulation in Anaesthesia. 6, better than train-of-four. Post-tetanic count assesses very deep block, and a single twitch does not show fade at all.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Muscle relaxants: double burst stimulation?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.