Abstract
BACKGROUND: Disturbances in the thumb's movement interfere with the functioning of acceleromyography in many clinical settings. The short and light (SL) train-of-four (TOF)-Tube is a new version of a rigid tubular device that was designed to protect the thumb from external disturbances during surgery, even when the hand is not accessible by the anaesthesiologist.
OBJECTIVE: To compare the precision and performance of acceleromyography performed with the aid of the SL TOF-Tube (AMGTT) with standard isometric mechanomyography (MMG).
DESIGN: Simultaneous arm-to-arm comparison of both methods in the same anaesthetised patient.
SETTING: A monocentric study, performed from September 2007 to June 2008.
PATIENTS: Nineteen ASA I to II patients scheduled to undergo lower limb orthopaedic surgery under general anaesthesia.
INTERVENTION: Neuromuscular transmission monitoring during baseline, onset and spontaneous recovery of rocuronium-induced neuromuscular block.
MAIN OUTCOME MEASURES: Initial baseline and repeatability coefficients were assessed during 10 consecutive measurements of the first twitch height (T1) and TOF T4/T1 ratio and compared using a z test. The spontaneous recoveries of defined blockade levels (onset, T1 25% of initial calibration and TOF ratio 0.9) were compared in terms of duration and intensity. Agreement between both techniques was assessed by the Bland-Altman method.
RESULTS: The mean ± SD control TOF ratios were 98 ± 1% (MMG) and 103 ± 2% (AMGTT). The repeatability coefficients were higher (P < 0.001) and the onset was longer (mean 0.44 min) (P < 0.001) when they were measured by AMGTT. The recoveries of T1 25% and TOF ratio 0.9 were not significantly different between the two methods, and the limits of agreement were in the usual range of contralateral comparisons (-19 and +24% for TOF ratio 0.9).
CONCLUSION: Compared with mechanomyography, acceleromyography performed with the aid of an SL TOF-Tube offered acceptable precision and equivalent performance during neuromuscular block recovery.
Original language | English |
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Pages (from-to) | 404-410 |
Number of pages | 7 |
Journal | European Journal of Anaesthesiology |
Volume | 31 |
Issue number | 8 |
DOIs | |
Publication status | Published - 2014 |
Keywords
- Accelerometry
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Androstanols
- Anesthesia, General
- Calibration
- Female
- Humans
- Isometric Contraction
- Lower Extremity
- Male
- Middle Aged
- Monitoring, Intraoperative
- Muscle Contraction
- Myography
- Neuromuscular Blockade
- Neuromuscular Nondepolarizing Agents
- Orthopedic Procedures
- Reproducibility of Results
- Young Adult
- Clinical Trial
- Comparative Study
- Journal Article