Comparison of train-of-four ratios measured with Datex-Ohmeda's M-NMT MechanoSensor and M-NMT ElectroSensor

Jarno Salminen (Corresponding Author), Mark van Gils, Markku Paloheimo, Arvi Yli-Hankala

Research output: Contribution to journalArticleScientificpeer-review

3 Citations (Scopus)

Abstract

Neuromuscular blockade is usually monitored using train-of-four (TOF) stimulation pattern. A TOF ratio of higher than 90 % is recommended to reduce the risk of adverse effects after anaesthesia. TOF ratio 90 % is used in clinical practice with all different neuromuscular monitors. Kinemyography (KMG) is one commercialized method to obtain numerical TOF values. We compared the KMG data obtained with Datex M-NMT MechanoSensorT module, to the EMG data collected with Datex ElectroSensorT, during clinical anaesthesia. Ipsilateral comparisons of the sensors were performed in 20 female patients during clinical procedures in propofol-remifentanil anaesthesia. After initial bolus dose of rocuronium (0.6 mg/kg), the spontaneous recovery of TOF ratio and T1 % were monitored. KMG gave higher TOF values than EMG. The difference was significant at KMG TOF values of 40 % or higher. After anaesthetic induction, but before administration of rocuronium, both TOF sensor values drifted from the TOF value of 1.0, showing either significant spontaneous fade (T1 > T4) or tendency of reverse fade (T1 <T4). KMG overestimates the recovery from neuromuscular blockade when compared with EMG. KMG and EMG cannot be used interchangeably, and TOF ratio 90 % cannot be considered as adequate level of recovery with all monitoring devices.
Original languageEnglish
Pages (from-to)295-300
JournalJournal of Clinical Monitoring and Computing
Volume30
Issue number3
DOIs
Publication statusPublished - 2016
MoE publication typeA1 Journal article-refereed

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Neuromuscular Blockade
Anesthesia
Propofol
Anesthetics
Equipment and Supplies
rocuronium
remifentanil

Keywords

  • Electromyography
  • EMG
  • Kinemyography
  • KMG
  • M-NMT MechanoSensor
  • Neuromuscular monitoring

Cite this

@article{c1adc23a753a46a38c252c0bbbd2efc6,
title = "Comparison of train-of-four ratios measured with Datex-Ohmeda's M-NMT MechanoSensor and M-NMT ElectroSensor",
abstract = "Neuromuscular blockade is usually monitored using train-of-four (TOF) stimulation pattern. A TOF ratio of higher than 90 {\%} is recommended to reduce the risk of adverse effects after anaesthesia. TOF ratio 90 {\%} is used in clinical practice with all different neuromuscular monitors. Kinemyography (KMG) is one commercialized method to obtain numerical TOF values. We compared the KMG data obtained with Datex M-NMT MechanoSensorT module, to the EMG data collected with Datex ElectroSensorT, during clinical anaesthesia. Ipsilateral comparisons of the sensors were performed in 20 female patients during clinical procedures in propofol-remifentanil anaesthesia. After initial bolus dose of rocuronium (0.6 mg/kg), the spontaneous recovery of TOF ratio and T1 {\%} were monitored. KMG gave higher TOF values than EMG. The difference was significant at KMG TOF values of 40 {\%} or higher. After anaesthetic induction, but before administration of rocuronium, both TOF sensor values drifted from the TOF value of 1.0, showing either significant spontaneous fade (T1 > T4) or tendency of reverse fade (T1 <T4). KMG overestimates the recovery from neuromuscular blockade when compared with EMG. KMG and EMG cannot be used interchangeably, and TOF ratio 90 {\%} cannot be considered as adequate level of recovery with all monitoring devices.",
keywords = "Electromyography, EMG, Kinemyography, KMG, M-NMT MechanoSensor, Neuromuscular monitoring",
author = "Jarno Salminen and {van Gils}, Mark and Markku Paloheimo and Arvi Yli-Hankala",
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Comparison of train-of-four ratios measured with Datex-Ohmeda's M-NMT MechanoSensor and M-NMT ElectroSensor. / Salminen, Jarno (Corresponding Author); van Gils, Mark; Paloheimo, Markku; Yli-Hankala, Arvi.

In: Journal of Clinical Monitoring and Computing, Vol. 30, No. 3, 2016, p. 295-300.

Research output: Contribution to journalArticleScientificpeer-review

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T1 - Comparison of train-of-four ratios measured with Datex-Ohmeda's M-NMT MechanoSensor and M-NMT ElectroSensor

AU - Salminen, Jarno

AU - van Gils, Mark

AU - Paloheimo, Markku

AU - Yli-Hankala, Arvi

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N2 - Neuromuscular blockade is usually monitored using train-of-four (TOF) stimulation pattern. A TOF ratio of higher than 90 % is recommended to reduce the risk of adverse effects after anaesthesia. TOF ratio 90 % is used in clinical practice with all different neuromuscular monitors. Kinemyography (KMG) is one commercialized method to obtain numerical TOF values. We compared the KMG data obtained with Datex M-NMT MechanoSensorT module, to the EMG data collected with Datex ElectroSensorT, during clinical anaesthesia. Ipsilateral comparisons of the sensors were performed in 20 female patients during clinical procedures in propofol-remifentanil anaesthesia. After initial bolus dose of rocuronium (0.6 mg/kg), the spontaneous recovery of TOF ratio and T1 % were monitored. KMG gave higher TOF values than EMG. The difference was significant at KMG TOF values of 40 % or higher. After anaesthetic induction, but before administration of rocuronium, both TOF sensor values drifted from the TOF value of 1.0, showing either significant spontaneous fade (T1 > T4) or tendency of reverse fade (T1 <T4). KMG overestimates the recovery from neuromuscular blockade when compared with EMG. KMG and EMG cannot be used interchangeably, and TOF ratio 90 % cannot be considered as adequate level of recovery with all monitoring devices.

AB - Neuromuscular blockade is usually monitored using train-of-four (TOF) stimulation pattern. A TOF ratio of higher than 90 % is recommended to reduce the risk of adverse effects after anaesthesia. TOF ratio 90 % is used in clinical practice with all different neuromuscular monitors. Kinemyography (KMG) is one commercialized method to obtain numerical TOF values. We compared the KMG data obtained with Datex M-NMT MechanoSensorT module, to the EMG data collected with Datex ElectroSensorT, during clinical anaesthesia. Ipsilateral comparisons of the sensors were performed in 20 female patients during clinical procedures in propofol-remifentanil anaesthesia. After initial bolus dose of rocuronium (0.6 mg/kg), the spontaneous recovery of TOF ratio and T1 % were monitored. KMG gave higher TOF values than EMG. The difference was significant at KMG TOF values of 40 % or higher. After anaesthetic induction, but before administration of rocuronium, both TOF sensor values drifted from the TOF value of 1.0, showing either significant spontaneous fade (T1 > T4) or tendency of reverse fade (T1 <T4). KMG overestimates the recovery from neuromuscular blockade when compared with EMG. KMG and EMG cannot be used interchangeably, and TOF ratio 90 % cannot be considered as adequate level of recovery with all monitoring devices.

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