A quantitative neuromuscular monitoring device is desirable to titrate the depth of neuromuscular block (NMB) during a procedure, and to prevent residual effects after removal of the endotracheal tube. Unfortunately, the most widely used monitoring technique acceleromyography (AMG) typically implies a series of cumbersome installation and calibration procedures that frequently precludes correct use of these devices in clinical practice. Electromyography (EMG) has recently attracted a lot of attention as an alternative strategy to compensate for the deficiency of AMG-based neuromuscular monitors. Nowadays, a new technology that allows for the simultaneous acquisition of EMG and AMG signals is commercially available. Although its reliability has been rapidly accepted in Physical Medicine and Rehabilitation, the use of the technique in neuromuscular monitoring has never been reported. The aim of the present study is to assess the validity of the new device for estimating the neuromuscular block by comparing with TOF Watch®-SX, which is the most widely accepted AMG-based neuromuscular monitor that has been practiced in the clinical arena for decades.
Age less than 18 yr
American Society of Anesthesiologists Physical Status I to III
Elective surgery requiring muscle relaxation
Patients participated voluntarily and signed informed consent
Patients with known neuromuscular disorder
Stroke
Patients with a history of allergic reaction toneuromuscular blocking agents
Use of medications that might interfere with neuromuscular transmission
Patients who need to be treated surgically under general anesthesia and are going to receive neuromuscular blocking agents.
Cohort
Prospective
TOF-Watch®；DELSYS® Wireless surface EMG
DeviceTOF-Watch® is the most widely accepted AMG-based neuromuscular monitor; and DELSYS® Wireless surface EMG is a new technology that allows for the simultaneous acquisition of EMG and AMG signals in a wireless manner.
Assessing the correlation between the train-of-four (TOF) obtained from the 2 devices
Assessing the correlation between the posttetanic count (PTC) obtained from the 2 devices
Screening for eligible individual signal sources from the multiplex information of the new technology for improving neuromuscular monitoring
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