الفهرس 
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Abstract
In patients with diabetes mellitus, the function of motor nerve and nerve endings may be impaired. Partial degeneration or segmental demyelination of the nerve and loss of motor units have been reported in diabetic patients, as a result of which motor nerve conduction velocity decreases.
Diabetic neuropathy can be classified as peripheral, autonomic, proximal, or focal. Each affects different parts of the body in various ways. Peripheral neuropathy, also called distal symmetric neuropathy or sensorimotor neuropathy, is nerve damage in the arms and legs. Peripheral neuropathy may also cause muscle weakness and loss of reflexes. The fuzzy model was elaborated based on the experience and knowledge of four diabetic neuropathy experts. These experts considered the following inputs as the most important.
Posttetanic count (PTC) is a well established method of evaluating neuromuscular recovery during intense neuromuscular blockade. It can be used when there is no response to single twitch, tetanic, or train-of four (TOF) stimulation to assess the intensity of neuromuscular blockade and to estimate the duration after which the first twitch in the TOF (T1) is likely to reappear. A close correlation has been found between PTC and TOF recovery from intense pancuronium, vecuronium, atracurium, and rocuronium induced neuromuscular blockade.
The aim of the study was is to compare the neuromuscular block in diabetic neurpathy patients when Rocuronium (2x ED95) is used in anaesthetized patients with diabetes mellitus Type 2 and non diabetic patient.
After approval of the ethical committee
The study was conducted on 60 adult patients scheduled for elective lower abdominal surgery in operating theaters of Suez Canal university hospital and devided into 2 equal groups diabetic group and control group.
After including the patient in the study the monitoring system automatically searches for the stimulus current needed to achieve the maximal response of the adductor pollicis muscle. The search began with 10-mA single twitch stimuli of 0.2 ms duration applied every 1 s and the electromyographic response is measured. The stimulating current will be increased in steps of 5 mA until the increase in current doesn’t increase the electromyographic response. Once the supramaximal current has been established, the electromyographic amplitude of T1 is considered to be the control response (T0). After recording T0, Rocuronium 0.6 mg/kg (2x ED95) will be administered by intra venous route to facilitate tracheal intubation. then lag,onset, recovery index ,TOFR 90% and post tetanic count one was recorded.
AT the end of operation extuabtion was done after optaining TOFR 90%.
After obtaining and statistcal analysis of result we concluded that
• Rocuronium 0.6 mg/kg has a faster onset and longer recovery index and longer time needed for extubation in diabetics than non-diabetics .