Final answer:
The appropriate level of NM blockade for intr-abdominal surgery depends on the procedure and patient. Succinylcholine has different TOF ratios in phase 1 and phase 2 blockade. It can be reversed with neostigmine, which has a greater effect on phase 2 blockade.
Step-by-step explanation:
The appropriate level of NM blockade for intr-abdominal surgery depends on the specific surgical procedure and patient factors. Generally, a moderate level of blockade is preferred to ensure optimal conditions for surgery. This can be achieved by monitoring train-of-four (TOF) ratio.
For succinylcholine, in phase 1 blockade, the TOF ratio is usually close to 0 as the drug causes depolarization and sustained muscle contraction. In phase 2 blockade, the TOF ratio increases as the muscle enters a repolarization state.
Succinylcholine can cause a fade response to tetanic stimulation during phase 2 blockade, but not during phase 1 blockade. This can help differentiate between the two phases.
The reversal of succinylcholine-induced neuromuscular blockade can be done with the administration of a cholinesterase inhibitor, such as neostigmine, combined with an anticholinergic medication to minimize side effects.
Neostigmine has a greater effect on phase 2 blockade compared to phase 1 blockade. It can reverse phase 2 blockade more effectively by increasing the concentration of acetylcholine and improving neuromuscular transmission.