Pediatric anesthesia & critical care

Intraoperative Electromyographic Monitoring in Children Less Than 1 Year of Age

Paediatr AnaesthPublished Prospective feasibility study

Authors' conclusion

In patients > 28 days and < 1 year of age, our preliminary data suggest that electromyography-based TOF monitoring can be used effectively.

Study context

Population
Patients < 1 year of age presenting for elective surgery requiring a non-depolarizing NMBA (rocuronium)36 with complete data
Participants
49 patients
Outcome
Feasibility of electromyography-based TOF monitoring (effective monitoring)
Methodological detailsComplete baseline not obtained in 2 patients; 11 did not receive sugammadex or sensor removed before recovery
  • Complete baseline not obtained in 2 patients; 11 did not receive sugammadex or sensor removed before recovery

Main finding

As reported in the abstract

Effective monitoring
Effective monitoring achieved in all patients
49

Observational data: associations, not effects.

Further findings

Baseline muscle action potential amplitude · mean baseline

Baseline amplitude (mV)
6.8 ± 2.2

Recovered muscle action potential amplitude · after sugammadex reversal at completion of the case

Recovered amplitude (mV)
4.7 ± 1.5

Baseline TOFR · mean baseline

Mean baseline TOFR
99% ± 16.3%

Recovered TOFR · recovery

Mean recovered TOFR
95% ± 10%

Complete neuromuscular recording (baseline to recovery)

Complete data obtained
36

Original publication

Intraoperative Electromyographic Monitoring in Children Less Than 1 Year of Age. Paediatr Anaesth. Published 27 August 2025. doi:10.1111/pan.70043

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