The main objective of the study is to compare the frequency of intraoperative spontaneous diaphragmatic movements and breath-initiation efforts in participants undergoing robotic and/or thoracic surgery under deep neuromuscular blockade (NMB), using either the TetraGraph or TwitchView applied to the dominant hand. These events will serve as objective indicators to evaluate each device's ability to monitor and maintain adequate deep NMB.
Adult male or female patients aged ≥ 18 years old.
Patients undergo elective abdominal laparoscopic/robotic or thoracic video-assisted (VAT) surgeries requiring general anesthesia for greater than 3 hours at The Ohio State University Wexner Medical Center.
Able to provide a signed, written informed consent.
Able to speak, read, and write in English.
Patients who require emergency surgery or an emergent intervention.
Any documented cognitive or psychological disorders that, in the investigator's opinion, can interfere with the patient's pain perception.
Vulnerable populations: pregnant females, prisoners, breastfeeding.
Presence of any medical condition that, in the opinion of the principal investigator, should exclude the patient from the study (patients with pre-existing neuromuscular diseases.