Neuromuscular monitoring using TOF-Cuff® versus TOF-Scan®: an observational study under clinical anesthesia conditions

Markle, Andrew; Graf, Nicole; Horn, Katja; Welter, JoEllen; Dullenkopf, Alexander

doi:10.23736/s0375-9393.20.14272-x

Cited by 8 publications

(7 citation statements)

References 18 publications

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“…Therefore, postoperative complications remain commonly derived from residual neuromuscular blockade [ 3 , 8 ]. Acceleromyography is the standard neuromuscular block monitoring in clinical practice; it relies on the train-of-four nerve stimulation pattern recommendation: or the ratio of the fourth twitch to the first twitch T4/T1 ratio [ 11 ]. A train-of-four ratio of 0.7–0.9 is associated with impaired airway protective reflexes, upper airway obstruction, and postoperative hypoxemia [ 6 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Rate of residual neuromuscular block using single-dose rocuronium in general anesthesia for ENT surgery: a retrospective cohort study

et al. 2023

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Introduction NMB facilitates intubating conditions in general anesthesia. However, it is associated with significant residual postoperative paralysis and morbidity. Objective To investigate the rate of underdiagnosed residual NMB based on two TOFR criteria (< 0.91 and < 1.00). Methods We performed a retrospective study adhering to STROBE guidelines. We included patients undergoing ENT surgery using single-dose neuromuscular block for balanced general anesthesia from June to December 2018. We collected demographic and anthropometric data, ASA score, NMBA dose, TOFR recordings at 5, 30 and 60 min and end of the surgery, anesthesia and surgery time, and administration of reversal agent. Statistical analysis included descriptive and dispersion measures statistics, curve and cross tables for residual NMB on different TOFR criteria with sub-analysis for AR, RR, and OR in patients over 65 years old. Results We included 57 patients, mean age 41; 43 females and 14 males. Mean anesthetic and surgical time were 139.4 and 116.1 min, respectively. All the patients received rocuronium under a mean ponderal single-dose of 0.48 mg/kg. Residual NMB rates were 29.9 and 49.1% for a TOFR < 0.91 and < 1.00, respectively. Older adults had an OR of 6.08 for residual NMB. Conclusions The rate of residual NMB was 29.9 to 49.1%, depending on the criteria used (TOFR < 0.91 and < 1.00, respectively). Patients above 65 years old had an increased risk of residual NMB (6.08 OR) and clinical symptoms related to residual NMB (11.75 OR). We recommend future research aiming to provide a specific surveillance protocol for patients above 65 years old, including shorter-action NMB, early reversal, and prolonged surveillance using the TOFR criteria of < 1.00 to identify patients at risk of residual NMB readily.

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Section: Introductionmentioning

confidence: 99%

Rate of residual neuromuscular block using single-dose rocuronium in general anesthesia for ENT surgery: a retrospective cohort study

et al. 2023

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“…The authors of the study stated that, despite these differences, the results obtained with these methods may be important in clinical settings. 32 In another study comparing TOF-Cuff and TOF-Scan over the rapid intubation sequence, no statistically significant difference was found between these devices. However, due to high variability and wide compliance limits found, the authors concluded that these devices cannot be used interchangeably.…”

Section: Main Sectionsmentioning

confidence: 94%

Methods for Clinical Monitoring of Neuromuscular Transmission in Anesthesiology – A Review

Radkowski,

Barańska,

Mieszkowski

et al. 2024

IJGM

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The administration of general anesthesia is a crucial aspect of surgery. However, it can pose significant risks to patients, such as respiratory depression and prolonged neuromuscular blockade. To avoid such complications, it is essential to monitor neuromuscular transmission during anesthesia. While clinical tests have been used for decades to evaluate muscle function, they are now known to be unreliable, and relying on them increases the risk of postoperative complications. Thankfully, there are now six methods available for neuromuscular monitoring during anesthesia: mechanomyography, acceleromyography, electromyography, kinemyography, phonomyography, and compressomyography. Each of these methods differs in terms of their approach and methodology, and their importance in clinical practice varies accordingly. Mechanomyography involves measuring the mechanical response of a muscle to nerve stimulation, while acceleromyography measures the acceleration of muscle contraction. Electromyography records the electrical activity of muscles, while kinemyography tracks muscle movement. Phonomyography records the sound waves produced by contracting muscles, and compressomyography involves monitoring the pressure changes in a muscle during contraction. Overall, understanding the differences between these methods and their clinical significance is crucial for anesthesiologists. This review aims to provide an updated understanding of the current methods available for neuromuscular monitoring during anesthesia, so that anesthesiologists can make informed decisions about patient care and reduce the risk of postoperative complications.

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“…5 Anestezi esnasındaki hipnoz seviyesi elektroensefalogram (EEG) sinyallerinden üretilen Bispektral İndeks [Bispectral Index (BIS ® )] veya "Spectral Entropy" ile değerlendirilirken, anestezi sırasında nöromusküler bloğun derecesi "train-of-four nerve stimulation" gibi nöromusküler monitörizasyon me-todları ile ölçülmektedir. 6,7 Bahsedilen monitörlerin spesifisitesi ve sensitivesi saptanmış olup, klinikte de yaygın olarak kullanılmaktadır. 8 Genel anestezi uygulamalarında asıl hedeflerden biri olan ağrının takibinde ise daha çok otonomik yanıtların değerlendirilmesine odaklanılmıştır.…”

Section: Genel Anestezi̇ni̇n Bi̇leşenleri̇ Ve Kavramlarunclassified

Monitoring of Analgesia Level During General Anesthesia: Traditional Review

ARPACI,

IŞIK

2023

Turkiye Klinikleri J Anest Reanim

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Neuromuscular monitoring using TOF-Cuff® versus TOF-Scan®: an observational study under clinical anesthesia conditions

Cited by 8 publications

References 18 publications

Rate of residual neuromuscular block using single-dose rocuronium in general anesthesia for ENT surgery: a retrospective cohort study

Rate of residual neuromuscular block using single-dose rocuronium in general anesthesia for ENT surgery: a retrospective cohort study

Methods for Clinical Monitoring of Neuromuscular Transmission in Anesthesiology – A Review

Monitoring of Analgesia Level During General Anesthesia: Traditional Review

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