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‘‘Tongue depressor test’’




‘‘Tongue depressor test’’ is a sensitive and useful  bedside test to asses the adequate recovery of  neuromuscular function.

At a TOF ratio of 0.70 most volunteers cannot retain a wooden tongue depressor between their incisor teeth against even minimal effort to remove it.

In general, full return of masseter strength does not occur until the TOF ratio exceeds 0.80.

The practical implication of this is that if at the end of a case it is difficult or impossible to remove a patient’s bite block, it is highly likely that adequate neuromuscular recovery has taken place.

Kopman AF, Yee PS, Neuman GG: Correlation of the train-of-four fade ratio with clinical signs and symptoms of residual curarization in awake volunteers.
Anesthesiology 1997; 86:765–71.
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