Normalization of acceleromyographic train-of-four ratio by baseline value for detecting residual neuromuscular block

Suzuki, Takahiro; Fukano, Naoko; Kitajima, Osamu; Saeki, Shigeru; Ogawa, Setsuro

doi:10.1093/bja/aei273

Cited by 96 publications

(69 citation statements)

References 14 publications

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“…19 The ba se li ne AMG-TOF ra ti os va ri ed wi dely [110.8 (91-149)] in the cur rent study, si mi lar to pre vi o us stu di es. 11,16,17,20 Even tho ugh the ba se li ne TOF ra ti os we re >1 in 71 (58.1%) pa ti ents, they were <1 in 29 (23.7%) pa ti ents. Thus, if PORC had been con si de red as a raw TOF ra ti o less than 1 in this study, five pa ti ents wo uld ha ve be en er ro ne o usly ac cep ted as ha ving PORC (po si ti ve pre dic ti ve valu e; 92%).…”

Section: Discussionmentioning

confidence: 94%

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High Incidence of Residual Curarization After Rocuronium Despite Administration of Neostigmine

Baykara¹,

Hoşten²,

Özdamar³

et al. 2010

Turkiye Klinikleri J Med Sci

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A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : The aim of the study was to in ves ti ga te the in ci den ce of pos to pe ra ti ve re sidu al curarization (PORC) af ter ro cu ro ni um ad mi nis tra ti on using nor ma li zed ac ce le rom yog rap hic (AMG) tra in-of-fo ur (TOF) ra ti os. M Ma at te er ri ia al l a an nd d M Me et t h ho od ds s: : Du ring pro po fol-fen tanyl-nit ro us oxi de anest he si a, ne u ro mus cu lar block was mo ni to red using ac ce le rom yog raphy met hod in 130 pa ti ents. A TOF ra ti o me a su red at the end of con trol sti mu la ti on was re cor ded as a ba se li ne TOF va lu e. Neu ro mus cu lar block was in du ced with ro cu ro ni um 0.6 mg.kg -1 and an ta go ni zed with ne os tig mi ne 40 μg.kg -1 at the end of anest he si a. Im me di a tely af ter the pa ti ents' ar ri val in the pos ta nest he tic ca re unit (PA CU), TOF ra ti os we re me a su red and nor ma li zed (i.e., di vi ding the raw TOF ra ti o by the ba seli ne TOF va lu e). The in ci den ces of PORC we re de ter mi ned ac cor ding to thre e dif fe rent TOF threshold va lu es: Nor ma li zed AMG-TOF ra ti o <1; raw AMG-TOF ra ti o <1; and raw AMG-TOF ra ti o < 0.9. R Re e s su ul lt ts s: : The ba se li ne AMG TOF ra ti os va ri ed wi dely 110.8 (91-149) among pa ti ents. Con si dering nor ma li zed AMG-TOF ra ti os <1 as PORC, 77 (63.1%) pa ti ents had PORC on ar ri val to the PA -CU. Sig ni fi cantly fe wer pa ti ents had raw TOF ra ti os < 0.9 (39 sub jects, 31.9%), and <1 (67 sub jects, 54.9%) than who se nor ma li zed TOF ra ti os <1 (77 sub jects, 63.1 %) (p< 0.05). Although not statistically significant, the when it was determined using normalized AMG-TOF ratios rather than using raw AMG-TOF ratios (18.3% and 10%, respectively). C Co on nc c l lu u s si i o on n: : Des pi te re ver sal of ne u ro muscu lar block with ne os tig mi ne, the in ci den ce of PORC is very high af ter ro cu ro ni um ad mi nis tra tion.K Ke ey y W Wo or rd ds s: : Mo ni to ring, physi o lo gic; ro cu ro ni um; comp li ca ti ons; ne u ro mus cu lar bloc ka de Ö ÖZ ZE ET T A Am ma aç ç: : Bu ça lış ma da ro ku ron yum son ra sı pos to pe ra tif re zi dü el kü ra ri zas yon (PORK) sık lı ğı -nın nor mal leş ti ril miş ak se le rom yog ra fik (AMG) tra in-of-fo ur (TOF) oran la rı kul la nı la rak be lir lenme si amaç lan mış tır. G Ge e r re eç ç v ve e Y Yö ön n t te em ml le er r: : Pro po fol-fen ta nil-nit roz ok sit anes te zi si sı ra sın da, 130 has ta da nö ro müs kü ler blok ak se le rom yog ra fi yön te miy le mo ni to ri ze edil di. Kon trol sti mü lasyo nu son ra sın da öl çü len TOF ora nı ba zal TOF de ğe ri ola rak ka bul edil di. Nö ro müs kü ler blok 0.6 mg.kg -1 ro ku ron yum la sağ lan dı ve anes te zi nin so nun da 40 μg.kg -1 ne os tig min le an ta go ni ze edil di. Has ta lar pos to pe ra tif der len me oda sı na gel dik ten he men son ra TOF oran la rı öl çül dü ve nor mal leş -ti ril di (ham TOF ora nı nın ba zal TOF de ğe ri ne bö lün me siy le). PORK sık lı ğı üç fark lı TOF eşik değe ri ne gö re be lir l...

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Section: Discussionmentioning

confidence: 94%

“…11,[15][16][17] That is, if, for examp le, the con trol AMG-TOF ra ti o is 1.1, a disp la yed (raw) TOF va lu e of 0.9 du ring re co very pe ri od corres ponds to a nor ma li zed TOF ra ti o of 0.81. Ho wever, it is ne ces sary to know the ba se li ne TOF ra ti o to apply the nor ma li za ti on met hod.…”

mentioning

confidence: 99%

High Incidence of Residual Curarization After Rocuronium Despite Administration of Neostigmine

Baykara¹,

Hoşten²,

Özdamar³

et al. 2010

Turkiye Klinikleri J Med Sci

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“…Easy to handle Suitable for any free-moving muscle [10] Not interchangeable with EMG/MMG TOFR overestimation by at least 0.15 [26,27] Baseline TOFR > 1.0 [28].…”

Section: Classic Amg: Tof-watch Infinitytrident Nmt Podmentioning

confidence: 99%

Neuromuscular monitoring: an update

Duţu

Ivascu

Tudorache

et al. 2018

Rom J Anaesth Int Care

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This review makes an advocacy for neuromuscular blockade monitoring during anaesthesia care, by: (i) describing the fundamental principles of the methods currently available, at the same time emphasizing quantitative recording measurements; (ii) describing the different ways in which muscles respond to the effect of neuromuscular blockade and their use in clinical practice; (iii) presenting results of different studies on timing and agents of neuromuscular block reversal, including a recommendation for sugammadex use and experimental results with calabadion and (iv) in the end emphasizing the need for implementing neuromuscular monitoring as a practice that should be used every time a neuromuscular block is required.

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Section: To the Editormentioning

confidence: 99%

“…3 Therefore a TOF ratio of 0.9 displayed during recovery does not always indicate adequate neuromuscular recovery unless the value is normalized with respect to baseline. 3 If a CRE occurs after neostigmine, prompt treatment is required and sugammadex should be considered the drug of choice. 1,2 Neostigmine may also reverse rocuronium-induced residual neuromuscular blockade (NMB), 4 but it is associated with side effects and has a relatively slow onset of action, particularly in morbidly obese patients.…”

Section: To the Editormentioning

confidence: 99%

Sugammadex for treatment of postoperative residual curarization in a morbidly obese patient

Carron

Freo

Ori

2012

Can J Anesth/J Can Anesth

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Normalization of acceleromyographic train-of-four ratio by baseline value for detecting residual neuromuscular block

Cited by 96 publications

References 14 publications

High Incidence of Residual Curarization After Rocuronium Despite Administration of Neostigmine

High Incidence of Residual Curarization After Rocuronium Despite Administration of Neostigmine

Neuromuscular monitoring: an update

Sugammadex for treatment of postoperative residual curarization in a morbidly obese patient

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