Journal article
Performance of acceleromyography with a short and light TOF-tube compared with mechanomyography: a clinical comparison.
- Dubois PE From the Department of Anaesthesiology, University of Louvain, CHU UCL Mont-Godinne-Dinant, Yvoir (PED, JM, MG, CD), MDB Engineering, Spin-off University of Brussels ULB, Brussels (MDB), Scientific Support Unit, University of Louvain, CHU UCL Mont-Godinne-Dinant, Yvoir, Belgium (JJ), and Department of Anaesthesiology, University Hospital, Geneva, Switzerland (AH).
- De Bel M
- Jamart J
- Mitchell J
- Gourdin M
- Dransart C
- d'Hollander A
- 2013-07-26
Published in:
- European journal of anaesthesiology. - 2014
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
Rocuronium
Young Adult
English
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.
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.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1097/EJA.0b013e3283645691
- PMID 23884404
- Persistent URL
- https://sonar.ch/global/documents/174664
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