• Citer

Performance of acceleromyography with a short and light TOF-tube compared with mechanomyography: A clinical comparison

par Dubois, Philippe;Mitchell, John;Gourdin, Maximilien;Dransart, Christophe;De Bel, Maxime ;Jamart, Jacques;D'Hollander, Alain
Référence European journal of anaesthesiology, 31, 8, page (404-410)
Publication Publié, 2014

Article révisé par les pairs

• Détails
• Contenu

Résumé :

BACKGROUND Disturbances in the thumb's movement interfere with the functioning of acceleromyography in many clinical settings. The short and light (SL) train-of-four (TOF)- Tube is a new version of a rigid tubular device that was designed to protect the thumb from external disturbances during surgery, even when the hand is not accessible by the anaesthesiologist. OBJECTIVE To compare the precision and performance of acceleromyography performed with the aid of the SL TOFTube (AMGTT) with standard isometric mechanomyography (MMG). DESIGN Simultaneous arm-to-arm comparison of both methods in the same anaesthetised patient. SETTING A monocentric study, performed from September 2007 to June 2008. PATIENTS NineteenASAI to II patients scheduled to undergo lower limb orthopaedic surgery under general anaesthesia. INTERVENTION Neuromuscular transmission monitoring during baseline, onset and spontaneous recovery of rocuronium- induced neuromuscular block. MAIN OUTCOME MEASURES Initial baseline and repeatability coefficients were assessed during 10 consecutive measurements of the first twitch height (T1) and TOF T4/ T1 ratio and compared using a z test. The spontaneous recoveries of defined blockade levels (onset, T1 25% of initial calibration and TOF ratio 0.9) were compared in terms of duration and intensity. Agreement between both techniques was assessed by the Bland-Altman method. RESULTS The meanSD control TOF ratios were 981% (MMG) and 1032% (AMGTT). The repeatability coefficients were higher (P<0.001) and the onset was longer (mean 0.44 min) (P<0.001) when they were measured by AMGTT. The recoveries of T1 25% and TOF ratio 0.9 were not significantly different between the two methods, and the limits of agreement were in the usual range of contralateral comparisons (±19 and R24% for TOF ratio 0.9). CONCLUSION Compared with mechanomyography, acceleromyography performed with the aid of an SL TOF-Tube offered acceptable precision and equivalent performance during neuromuscular block recovery. © 2014 Copyright European Society of Anaesthesiology.