Pediatric anesthesia & critical care
Pediatric Intraoperative Electromyographic Responses at the Adductor Pollicis and Flexor Hallucis Brevis Muscles: A Prospective, Comparative Analysis
Authors' conclusion
Although this study in young children demonstrated the feasibility of TOF monitoring, interpretation of the depth of neuromuscular block needs to consider the delayed onset and the delayed recovery of TOFR at the foot compared to the hand.
Study context
- Population
- Pediatric patients undergoing inpatient surgery requiring NMBA administrationmean age 3.0 ± SD 2.9 years
- Participants
- 50 patients
- Exposure
- Electromyographic (EMG) monitoring at the foot vs the hand
- Outcome
- Evoked EMG responses, foot vs hand
Methodological detailswithin-patient simultaneous monitoring at 2 sites
- Within-patient simultaneous monitoring at 2 sites
Main finding
As reported in the abstract
Difference in baseline T1 amplitude
4.47 mV
P < 0.0001
foot T1 12.46 mV
Delay in onset time (T1 to 10% or 5% of baseline)
≈90 seconds
P = 0.014
both P =.014
Delay in TOF ratio (TOFR) recovery to ≥0.9
191 seconds
P = 0.017
Evoked EMG responses, foot vs hand
Observational data: associations, not effects.
Further findings
| Outcome | Hand | Foot | P value |
|---|---|---|---|
| Fractional T1 recovery after antagonism (maximum T1 at recovery / baseline T1)Not different | 0.81 | 0.77 | P = 0.68 |
- Fractional T1 recovery after antagonism (maximum T1 at recovery / baseline T1): T1 did not return to baseline, typical with EMG monitoring
Original publication
Pediatric Intraoperative Electromyographic Responses at the Adductor Pollicis and Flexor Hallucis Brevis Muscles: A Prospective, Comparative Analysis. Anesth Analg. Published 17 June 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →