Anaesthetic drugs & techniques
Prospective, randomized comparison of electromyographic neuromuscular responses from the adductor pollicis and abductor digiti minimi muscles during rocuronium-induced neuromuscular block
Authors' conclusion
The present study underscores the equivalency between ADM and AP muscles for routine neuromuscular monitoring during surgery. When monitoring the non-dominant arm, the ADM and AP muscles have similar recoveries. In the dominant arm, the ADM muscle recovery is significantly faster than that of the AP muscle.
Study context
- Population
- Patients undergoing GA with rocuronium NMB and sugammadex reversal
- Participants
- 44 patients
- Comparison
- Electromyography (EMG) monitoring at abductor digiti minimi (ADM) vs adductor pollicis (AP) muscle, recorded simultaneously
- Primary endpoint
- Onset time (rocuronium to train-of-four (TOF) count =0); recovery time (sugammadex to TOFR ≥0.9); time to maximal recovery (sugammadex to TOFR=1.0)
Methodological detailsprospective, within-patient comparison, randomized hand allocation
- Prospective
- Within-patient comparison, randomized hand allocation
Primary result
As reported in the abstract
Onset time, recovery to TOFR ≥0.9, time to maximal recovery
- No significant differences between ADM and AP
Further findings
| Outcome | Mean difference (s) |
|---|---|
| Recovery times, right hand monitored (subgroup)ADM vs AP · time to TOFR ≥0.9; ADM 25% faster | 93 |
| Recovery times, right hand monitored (subgroup)ADM vs AP · time to TOFR=1.0; ADM 20% faster | 105 |
Recovery times, left hand monitored (subgroup)
- No difference between AP and ADM
Original publication
Prospective, randomized comparison of electromyographic neuromuscular responses from the adductor pollicis and abductor digiti minimi muscles during rocuronium-induced neuromuscular block. Anesthesiology. Published 17 September 2026. doi:10.
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