Accuracy and Precision of Three Acceleromyographs, Three Electromyographs, and a Mechanomyograph Measuring the Train-of-four Ratio in the Absence of Neuromuscular Blocking Drugs
Authors' conclusion
Three currently available acceleromyograph monitors produced overshoot and substantial variability that could be clinically significant. Normalization corrected the overshoot in the average results but did not reduce the wide variability. Three electromyograph monitors measured the train-of-four ratio with minimal overshoot and variability, similar to a mechanomyograph.
Study context
- Population
- Patients having surgery under GA with a supraglottic airway and without any NMBA9,498 TOFR measurements
- Participants
- 28 patients
- Comparison
- Acceleromyography vs Electromyography vs Mechanomyography
- Outcome
- Accuracy and precision of the TOFR (expected 1.0 without NMBA)
Methodological detailsgauge repeatability and reproducibility analysis
- Gauge repeatability and reproducibility analysis
Main finding
As reported in the abstract
Train-of-four ratio without neuromuscular blocking drugs (expected 1.0)
Acceleromyography
1.10 to 1.13
estimated means · gauge SD 0.07–0.18
- Electromyography and mechanomyography: TOF ratios outside 0.9 to 1.1
- 0.3%
- Acceleromyography: normalized TOF ratios outside 0.9 to 1.1
- 27 to 51%
Further findings
- Normalized acceleromyography TOFR
- 0.97 to 1.0 · estimated mean · gauge SDs 0.06–0.17
Normalized acceleromyography TOFR
- Normalization improved the mean but not the variability
Original publication
Accuracy and Precision of Three Acceleromyographs, Three Electromyographs, and a Mechanomyograph Measuring the Train-of-four Ratio in the Absence of Neuromuscular Blocking Drugs. Anesthesiology. Published 10 May 2024. doi:10.
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