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 language | English |
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Pages (from-to) | 295-300 |
Journal | Journal of Clinical Monitoring and Computing |
Volume | 30 |
Issue number | 3 |
DOIs | |
Publication status | Published - 2016 |
MoE publication type | A1 Journal article-refereed |
Keywords
- Electromyography
- EMG
- Kinemyography
- KMG
- M-NMT MechanoSensor
- Neuromuscular monitoring