Comparison of visual and electromyographic assessments with train-of-four stimulation of the ulnar nerve: a prospective cohort study
Authors' conclusion
Subjective observations of a "twitch" do not consistently correspond to objective measurements of neuromuscular blockade with electromyography. Subjective evaluation overestimates the response to neurostimulation
Study context
- Population
- Patients under nondepolarizing neuromuscular blockade333 time points
- Participants
- 50 participants
- Exposure
- Subjective vs Electromyography
- Outcome
- Agreement of subjective evaluations with objective electromyographic measurements of the response to TOF stimulation of the ulnar nerve
Methodological detailsclinicians blinded to objective measurements, randomised arm for EMG electrodes
- Clinicians blinded to objective measurements
- Randomised arm for EMG electrodes
Main finding
As reported in the abstract
Subjective overestimation of the adductor pollicis response vs EMG
Subjective evaluation overestimated the response, all time points: 155/333
47%
Subjective higher than objective where the two differed: 155/166
92%
95% CI 87 to 95P < 0.001
Observational data: associations, not effects.
Original publication
Comparison of visual and electromyographic assessments with train-of-four stimulation of the ulnar nerve: a prospective cohort study. Can J Anaesth. Published 29 March 2023. doi:10.
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