Comparison of Contralateral Acceleromyography and Electromyography for Posttetanic Count Measurement
Authors' conclusion
Acceleromyography frequently counted more twitches than electromyography in posttetanic count monitoring. Acceleromyography- and electromyography-posttetanic counts cannot be used interchangeably to assess the degree of neuromuscular blockade.
Study context
- Population
- Patients aged 20 to 65 yr given rocuronium 0.6 mg/kg (additional 0.3 mg/kg if required)226 measurement pairs analysed
- Participants
- 36 patients
- Comparison
- Acceleromyography vs electromyography for posttetanic count
- Outcome
- Agreement of NMB status (intense block, posttetanic count 0; deep block, posttetanic count ≥1 and TOF count 0) and of posttetanic count between acceleromyography and electromyography
Methodological detailscontralateral arm monitoring, Posttetanic count measured at 6-min intervals until TOF count reached 1
- Contralateral arm monitoring
- Posttetanic count measured at 6-min intervals until TOF count reached 1
Main finding
As reported in the abstract
Agreement of NMB status (intense or deep block)
Percentage agreement of NMB status
73%
Cohen's kappa
0.26
Further findings
| Outcome | Difference in mean posttetanic count (lower) (%) (95% CI) | P value |
|---|---|---|
| Agreement of posttetanic count (acceleromyography-posttetanic counts >15 excluded; 184 pairs) | 38 (20–51%) | P = 0.0002 |
- Agreement of posttetanic count (acceleromyography-posttetanic counts >15 excluded; 184 pairs) — Pairs with same acceleromyography and electromyography posttetanic count
- 42 (23%)
- Agreement of posttetanic count (acceleromyography-posttetanic counts >15 excluded; 184 pairs) — Pairs with acceleromyography count more than electromyography count
- 93 (50%)
Original publication
Comparison of Contralateral Acceleromyography and Electromyography for Posttetanic Count Measurement. Anesthesiology. Published 15 December 2022. doi:10.
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