A New Method of Monitoring the Effect of Muscle Relaxants on Laryngeal Muscles Using Surface Laryngeal Electromyography

Hemmerling, Thomas M.; Schurr, Christian; Walter, Sven; Dern, Sara; Schmidt, Joachim; Braun, G. G.

doi:10.1097/00000539-200002000-00047

Cited by 10 publications

(5 citation statements)

References 4 publications

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“…We used the square of the correlation coefficient (R 2 ) to guide the line of best fit. The line of best fit was used to determine the time from the end of injection to 90% reduction of baseline EMG activity (Onset 90 ), the time to maximum reduction (Onset peak ), and the maximum reduction of the neuromuscular response (peak effect) 10. The time from the end of injection to the return of 25%, 50%, 75% and 95% of baseline EMG activity was also determined from the line of best fit and used to characterize recovery of neuromuscular function 11…”

Section: Methodsmentioning

confidence: 99%

Onset and Duration of Intravenous and Intraosseous Rocuronium in Swine

Loughren¹,

Banks²,

Naluan³

et al. 2014

WestJEM

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IntroductionThe intraosseous (IO) route has become a popular method to gain access to the peripheral circulation in emergency situations. Despite little supporting data, it is generally believed that IO absorption is immediate and equivalent to the intravenous (IV) route. It is important to determine if rocuronium can effectively be administered by the IO route. The aim of the study was to determine and compare the onset and duration of rocuronium when administered via the IO and IV routes in a normovolemic pig model.MethodsWe recorded electromyographic (EMG) data following tibial IO and peripheral IV administration of rocuronium (1.2 mg/kg) in 10 swine weighing between 56 and 71 Kg. We transformed data were transformed to percent of baseline, determined onset and recovery characteristics.ResultsThe onset EMG-time profiles for IO and IV administration were very similar: tibial IO compared to IV administration did not statistically alter the onset of paralysis. The IO group took statistically longer than the IV group to return to 50 (p=0.042), 75 (p=0.034) and 95 (p=0.036) percent of baseline activity.ConclusionThe duration of effect is statistically longer after IO administration but is more of an academic interest than a clinical concern. The results of this study suggest that rocuronium can effectively be administered via the IO route without the need for dose adjustments.

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Section: Methodsmentioning

confidence: 99%

Onset and Duration of Intravenous and Intraosseous Rocuronium in Swine

Loughren¹,

Banks²,

Naluan³

et al. 2014

WestJEM

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show abstract

“…8 We have presented a new method of surface laryngeal EMG monitoring for determination of NMB. 7 The purpose of this study was to confirm that increasing NMB and laryngeal sinus diameter might did not cause loss of contact between surface electrode and vocal cords and, thus, underestimate peak effect and onset time. We therefore compared onset and peak effect of the NMB of cisatracurium using surface laryngeal with intramuscular EMG via straight needle electrodes.…”

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confidence: 92%

Surfacevs intramuscular laryngeal electromyography

Hemmerling

Schmidt

Wolf

et al. 2000

Can J Anesth/J Can Anesth

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“…It has been shown that clinical assessment of correct LMA placement based on a perception of unimpaired air-movement does not always lead to identifying LMA malposition [27]. Fiberscopy after insertion of the LMA is recommended as a useful way of assessing the mask position as the LMA can allow adequate ventilation even if sub-optimally placed [28]. However, fiberscopy was not routinely available in the hospitals taking part in the study or used by any of the instructors.…”

Section: Discussionmentioning

confidence: 99%

The effects of laryngeal mask airway passage simulation training on the acquisition of undergraduate clinical skills: a randomised controlled trial

et al. 2011

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BackgroundEffective use of the laryngeal mask airway (LMA) requires learning proper insertion technique in normal patients undergoing routine surgical procedures. However, there is a move towards simulation training for learning practical clinical skills, such as LMA placement. The evidence linking different amounts of mannequin simulation training to the undergraduate clinical skill of LMA placement in real patients is limited. The purpose of this study was to compare the effectiveness in vivo of two LMA placement simulation courses of different durations.MethodsMedical students (n = 126) enrolled in a randomised controlled trial. Seventy-eight of these students completed the trial. The control group (n = 38) received brief mannequin training while the intervention group (n = 40) received additional more intensive mannequin training as part of which they repeated LMA insertion until they were proficient. The anaesthetists supervising LMA placements in real patients rated the participants' performance on assessment forms. Participants completed a self-assessment questionnaire.ResultsAdditional mannequin training was not associated with improved performance (37% of intervention participants received an overall placement rating of > 3/5 on their first patient compared to 48% of the control group, X2 = 0.81, p = 0.37). The agreement between the participants and their instructors in terms of LMA placement success rates was poor to fair. Participants reported that mannequins were poor at mimicking reality.ConclusionsThe results suggest that the value of extended mannequin simulation training in the case of LMA placement is limited. Educators considering simulation for the training of practical skills should reflect on the extent to which the in vitro simulation mimics the skill required and the degree of difficulty of the procedure.

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A New Method of Monitoring the Effect of Muscle Relaxants on Laryngeal Muscles Using Surface Laryngeal Electromyography

Cited by 10 publications

References 4 publications

Onset and Duration of Intravenous and Intraosseous Rocuronium in Swine

Onset and Duration of Intravenous and Intraosseous Rocuronium in Swine

Surfacevs intramuscular laryngeal electromyography

The effects of laryngeal mask airway passage simulation training on the acquisition of undergraduate clinical skills: a randomised controlled trial

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