• Can J Anaesth · Feb 2004

    Comparative Study Clinical Trial Controlled Clinical Trial

    Comparison of phonomyography with balloon pressure mechanomyography to measure contractile force at the corrugator supercilii muscle.

    • Thomas M Hemmerling, Guillaume Michaud, Denis Babin, Guillaume Trager, and François Donati.
    • Neuromuscular Research Group, Department of Anesthesiology, Centre hospitalier de l'université de Montréal, Hôtel-Dieu, Université de Montréal, Montréal, Québec, Canada. thomashemmerling@hotmail.com
    • Can J Anaesth. 2004 Feb 1;51(2):116-21.

    PurposePhonomyography is based on the creation of low frequency sounds during muscle contraction, which can be recorded and used for neuromuscular monitoring. In this study, balloon pressure mechanomyography, a novel method to measure the force of contraction via pressure changes in an air-filled balloon, was compared with phonomyography to determine neuromuscular blockade at the corrugator supercilii muscle.MethodAfter approval of the Ethics Committee and informed consent, 15 patients were studied. A small condenser microphone was taped to the area just above the eyebrow for phonomyography; an air-filled balloon was taped to the area just above the opposite eyebrow. After induction of anesthesia using remifentanil and propofol, a laryngeal mask airway was inserted without the aid of neuromuscular blocking agents. The facial nerve was stimulated supramaximally with single-twitch stimulation (0.1 Hz) using superficial electrodes placed on both temporal areas for onset and train-of-four stimulation every 12 sec during offset of neuromuscular blockade produced by mivacurium 0.1 mg.kg(-1). Onset and recovery measured by the two methods were compared using the t test and agreement between phonomyography and balloon pressure mechanomyography was examined using the Bland-Altman method.ResultsOnset, peak effect, and time to reach 25%, 75%, and 90% of control twitch response for phonomyography vs balloon pressure method were 83 +/- 16 sec vs 81 +/- 15 sec, 80 +/- 15% vs 82 +/- 17%, 7.7 +/- 2.3 min vs 7.5 +/- 2.4 min, 9.9 +/- 4.1 min vs 10.5 +/- 4 min, and 12.6 +/- 4.3 min vs 13.1 +/- 4.5 min respectively without being significantly different. Mean bias was 1% with limits of agreement of -9 and +9% of twitch height (T1).ConclusionWe applied a balloon pressure method to measure the force at the corrugator supercilii. Phonomyography at the corrugator supercilii shows good agreement with this modified version of mechanomyography.

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